| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $3,536.68 | $3,536.68 | |
CareSource
| Facility | $3,972.17 | $4,615.68 | $5,028.85 | |
Cigna
| Facility | $4,251.34 | $4,251.34 | $4,251.34 | |
Cigna
| Facility | 62 | $2,621.39 | $2,621.39 | $2,621.39 |