| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $950.28 | $950.28 | $1,400.00 | |
CareSource
| Facility | $1,006.46 | $1,147.55 | $1,250.28 | |
Cigna
| Facility | $1,078.98 | $1,078.98 | $1,078.98 | |
Cigna
| Facility | AS | $105.77 | $105.77 | $105.77 |