| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,746.62 | $2,746.62 | |
CareSource
| Facility | $2,766.96 | $3,169.10 | $3,452.79 | |
Cigna
| Facility | $2,967.34 | $2,967.34 | $2,967.34 | |
Cigna
| Facility | AS | $288.70 | $288.70 | $288.70 |