| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $3,402.90 | $3,402.90 | |
CareSource
| Facility | $3,410.54 | $3,913.78 | $4,264.12 | |
Cigna
| Facility | $3,662.87 | $3,662.87 | $3,662.87 | |
Cigna
| Facility | AS | $355.74 | $355.74 | $355.74 |