| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,544.05 | $2,544.05 | |
CareSource
| Facility | $2,555.94 | $2,930.50 | $3,192.82 | |
Cigna
| Facility | $2,741.69 | $2,741.69 | $2,741.69 | |
Cigna
| Facility | AS | $266.52 | $266.52 | $266.52 |