| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,037.29 | $2,037.29 | |
CareSource
| Facility | $2,036.25 | $2,341.73 | $2,551.35 | |
Cigna
| Facility | $2,189.10 | $2,189.10 | $2,189.10 | |
Cigna
| Facility | AS | $211.99 | $211.99 | $211.99 |