| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $960.14 | $1,400.00 | $1,700.00 | |
CareSource
| Facility | $1,033.42 | $1,156.40 | $1,259.93 | |
Cigna
| Facility | $1,102.93 | $1,102.93 | $1,102.93 | |
Cigna
| Facility | AS | $109.46 | $109.46 | $109.46 |