| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,620.87 | $2,741.34 | |
CareSource
| Facility | $1,832.98 | $2,122.96 | $2,313.01 | |
Cigna
| Facility | $1,963.31 | $1,963.31 | $1,963.31 | |
Cigna
| Facility | AS | $194.61 | $194.61 | $194.61 |