| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $925.71 | $925.71 | $1,400.00 | |
CareSource
| Facility | $945.74 | $1,075.60 | $1,171.89 | |
Cigna
| Facility | $1,011.55 | $1,011.55 | $1,011.55 | |
Cigna
| Facility | AS | $99.43 | $99.43 | $99.43 |