| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $811.54 | $1,267.52 | $1,561.95 | |
CareSource
| Facility | $890.30 | $981.60 | $1,069.47 | |
Cigna
| Facility | $1,427.58 | $1,427.58 | $1,427.58 | |
Cigna
| Facility | AS | $142.76 | $142.76 | $142.76 |