| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $961.97 | $1,400.00 | $2,600.00 | |
CareSource
| Facility | $1,035.21 | $1,176.94 | $1,282.30 | |
Cigna
| Facility | $1,110.36 | $1,110.36 | $1,110.36 | |
Cigna
| Facility | AS | $110.17 | $110.17 | $110.17 |