| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,760.42 | $1,760.42 | |
CareSource
| Facility | $1,997.19 | $2,233.92 | $2,433.90 | |
Cigna
| Facility | $2,150.11 | $2,150.11 | $2,150.11 | |
Cigna
| Facility | 52 | $1,691.71 | $1,691.71 | $1,691.71 |
Cigna
| Facility | AS | $211.46 | $211.46 | $211.46 |