| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $3,321.01 | $5,064.68 | |
CareSource
| Facility | $3,427.44 | $3,922.24 | $4,273.33 | |
Cigna
| Facility | $3,677.58 | $3,677.58 | $3,677.58 | |
Cigna
| Facility | 62 | $2,244.61 | $2,244.61 | $2,244.61 |