| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $3,630.41 | $5,524.03 | |
CareSource
| Facility | $3,735.70 | $4,277.96 | $4,660.89 | |
Cigna
| Facility | $4,013.89 | $4,013.89 | $4,013.89 | |
Cigna
| Facility | 62 | $2,448.96 | $2,448.96 | $2,448.96 |
Cigna
| Facility | AS | $391.83 | $391.83 | $391.83 |