| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,549.17 | $2,549.17 | |
CareSource
| Facility | $2,567.65 | $2,939.51 | $3,202.63 | |
Cigna
| Facility | $2,752.90 | $2,752.90 | $2,752.90 | |
Cigna
| Facility | AS | $267.95 | $267.95 | $267.95 |