| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,571.08 | $2,657.36 | |
CareSource
| Facility | $1,777.52 | $2,057.92 | $2,242.15 | |
Cigna
| Facility | $1,911.91 | $1,911.91 | $1,911.91 | |
Cigna
| Facility | AS | $189.62 | $189.62 | $189.62 |