| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,692.80 | $2,565.31 | |
CareSource
| Facility | $1,752.16 | $1,986.65 | $2,164.48 | |
Cigna
| Facility | $1,879.13 | $1,879.13 | $1,879.13 | |
Cigna
| Facility | AS | $184.06 | $184.06 | $184.06 |