| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,097.04 | $2,097.04 | |
CareSource
| Facility | $2,116.54 | $2,423.21 | $2,640.13 | |
Cigna
| Facility | $2,268.14 | $2,268.14 | $2,268.14 | |
Cigna
| Facility | AS | $220.75 | $220.75 | $220.75 |