| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $774.15 | $1,209.23 | $2,625.87 | |
CareSource
| Facility | $755.77 | $906.92 | $1,133.66 | |
Cigna
| Facility | $866.56 | $866.56 | $866.56 | |
Cigna
| Facility | 62 | $531.50 | $531.50 | $531.50 |
Cigna
| Facility | AS | $85.04 | $85.04 | $85.04 |