| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,077.42 | $16,126.64 | $16,126.64 | |
CareSource
| Facility | $752.78 | $834.38 | $909.08 | |
Cigna
| Facility | $806.35 | $806.35 | $806.35 | |
Cigna
| Facility | AS | $78.93 | $78.93 | $78.93 |