| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,603.52 | $2,451.60 | |
CareSource
| Facility | $1,665.58 | $1,898.58 | $2,068.54 | |
Cigna
| Facility | $1,784.51 | $1,784.51 | $1,784.51 | |
Cigna
| Facility | AS | $175.15 | $175.15 | $175.15 |