| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,291.06 | $18,235.06 | $18,235.06 | |
CareSource
| Facility | $895.04 | $999.83 | $1,089.33 | |
Cigna
| Facility | $957.12 | $957.12 | $957.12 | |
Cigna
| Facility | AS | $95.07 | $95.07 | $95.07 |