| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $3,544.16 | $3,544.16 | |
CareSource
| Facility | $3,558.00 | $4,083.17 | $4,448.68 | |
Cigna
| Facility | $3,817.28 | $3,817.28 | $3,817.28 | |
Cigna
| Facility | AS | $370.77 | $370.77 | $370.77 |