| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,045.15 | $57,752.66 | $57,752.66 | |
CareSource
| Facility | $726.79 | $809.40 | $881.85 | |
Cigna
| Facility | $778.94 | $778.94 | $778.94 | |
Cigna
| Facility | AS | $77.17 | $77.17 | $77.17 |