| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $966.61 | $1,400.00 | $1,700.00 | |
CareSource
| Facility | $1,036.46 | $1,158.32 | $1,262.02 | |
Cigna
| Facility | $1,107.38 | $1,107.38 | $1,107.38 | |
Cigna
| Facility | AS | $109.98 | $109.98 | $109.98 |