| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $984.00 | $1,400.00 | $2,300.00 | |
CareSource
| Facility | $1,057.77 | $1,182.85 | $1,288.75 | |
Cigna
| Facility | $1,130.08 | $1,130.08 | $1,130.08 | |
Cigna
| Facility | AS | $112.33 | $112.33 | $112.33 |