| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,433.98 | $3,050.00 | |
CareSource
| Facility | $1,628.74 | $1,882.03 | $2,050.50 | |
Cigna
| Facility | $1,745.28 | $1,745.28 | $1,745.28 | |
Cigna
| Facility | AS | $172.99 | $172.99 | $172.99 |