| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $926.35 | $1,400.00 | $1,700.00 | |
CareSource
| Facility | $994.41 | $1,113.13 | $1,212.77 | |
Cigna
| Facility | $1,062.48 | $1,062.48 | $1,062.48 | |
Cigna
| Facility | AS | $105.51 | $105.51 | $105.51 |