| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $991.89 | $991.89 | $1,400.00 | |
CareSource
| Facility | $1,047.98 | $1,193.76 | $1,300.61 | |
Cigna
| Facility | $1,122.24 | $1,122.24 | $1,122.24 | |
Cigna
| Facility | AS | $110.06 | $110.06 | $110.06 |