| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $994.71 | $1,200.00 | $1,553.82 | |
CareSource
| Facility | $1,044.86 | $1,203.32 | $1,311.04 | |
Cigna
| Facility | $1,115.59 | $1,115.59 | $1,115.59 | |
Cigna
| Facility | AS | $109.42 | $109.42 | $109.42 |