| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,773.20 | $2,688.16 | |
CareSource
| Facility | $1,836.94 | $2,081.78 | $2,268.14 | |
Cigna
| Facility | $1,973.23 | $1,973.23 | $1,973.23 | |
Cigna
| Facility | AS | $193.42 | $193.42 | $193.42 |