| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,418.46 | $2,418.46 | |
CareSource
| Facility | $2,726.31 | $3,184.04 | $3,469.07 | |
Cigna
| Facility | $2,923.03 | $2,923.03 | $2,923.03 | |
Cigna
| Facility | AS | $289.31 | $289.31 | $289.31 |