| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $3,133.90 | $3,133.90 | |
CareSource
| Facility | $3,509.88 | $4,049.84 | $4,412.37 | |
Cigna
| Facility | $3,797.86 | $3,797.86 | $3,797.86 | |
Cigna
| Facility | 62 | $2,356.92 | $2,356.92 | $2,356.92 |