| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,839.68 | $2,790.98 | |
CareSource
| Facility | $1,912.88 | $2,161.40 | $2,354.89 | |
Cigna
| Facility | $2,052.10 | $2,052.10 | $2,052.10 | |
Cigna
| Facility | AS | $200.73 | $200.73 | $200.73 |