| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $866.62 | $1,400.00 | $18,900.84 | |
CareSource
| Facility | $935.51 | $1,043.28 | $1,136.67 | |
Cigna
| Facility | $1,002.12 | $1,002.12 | $1,002.12 | |
Cigna
| Facility | AS | $99.62 | $99.62 | $99.62 |