| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,340.35 | $18,805.50 | $18,805.50 | |
CareSource
| Facility | $2,219.46 | $2,586.85 | $2,818.42 | |
Cigna
| Facility | $2,375.41 | $2,375.41 | $2,375.41 | |
Cigna
| Facility | AS | $235.29 | $235.29 | $235.29 |