| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $598.48 | $937.73 | $1,400.00 | |
CareSource
| Facility | $655.78 | $726.20 | $791.21 | |
Cigna
| Facility | $1,051.54 | $1,051.54 | $1,051.54 | |
Cigna
| Facility | AS | $105.15 | $105.15 | $105.15 |