| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,686.35 | $2,859.90 | |
CareSource
| Facility | $1,909.62 | $2,214.78 | $2,413.04 | |
Cigna
| Facility | $2,047.60 | $2,047.60 | $2,047.60 | |
Cigna
| Facility | AS | $202.96 | $202.96 | $202.96 |