| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $908.80 | $1,400.00 | $1,600.00 | |
CareSource
| Facility | $993.98 | $1,109.34 | $1,208.66 | |
Cigna
| Facility | $1,064.61 | $1,064.61 | $1,064.61 | |
Cigna
| Facility | AS | $104.84 | $104.84 | $104.84 |