| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,075.51 | $2,075.51 | |
CareSource
| Facility | $2,352.28 | $2,738.05 | $2,983.15 | |
Cigna
| Facility | $2,520.85 | $2,520.85 | $2,520.85 | |
Cigna
| Facility | AS | $250.20 | $250.20 | $250.20 |
United
| Facility | $765.00 | $765.00 | $765.00 |