| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $954.93 | $1,400.00 | $2,600.00 | |
CareSource
| Facility | $1,016.91 | $1,131.08 | $1,232.33 | |
Cigna
| Facility | $1,096.83 | $1,096.83 | $1,096.83 | |
Cigna
| Facility | AS | $109.68 | $109.68 | $109.68 |