| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,158.16 | $2,158.16 | |
CareSource
| Facility | $2,436.85 | $2,846.08 | $3,100.84 | |
Cigna
| Facility | $2,612.92 | $2,612.92 | $2,612.92 | |
Cigna
| Facility | AS | $258.70 | $258.70 | $258.70 |