| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $987.36 | $1,400.00 | $2,300.00 | |
CareSource
| Facility | $1,055.16 | $1,183.49 | $1,289.44 | |
Cigna
| Facility | $1,129.30 | $1,129.30 | $1,129.30 | |
Cigna
| Facility | AS | $111.81 | $111.81 | $111.81 |