| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,604.04 | $3,050.00 | |
CareSource
| Facility | $1,597.66 | $1,839.90 | $2,004.60 | |
Cigna
| Facility | $1,718.06 | $1,718.06 | $1,718.06 | |
Cigna
| Facility | 62 | $1,039.23 | $1,039.23 | $1,039.23 |
Cigna
| Facility | AS | $166.28 | $166.28 | $166.28 |