| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $3,285.34 | $3,285.34 | |
CareSource
| Facility | $3,297.09 | $3,782.50 | $4,121.09 | |
Cigna
| Facility | $3,538.31 | $3,538.31 | $3,538.31 | |
Cigna
| Facility | AS | $343.67 | $343.67 | $343.67 |