| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $958.89 | $1,400.00 | $3,050.00 | |
CareSource
| Facility | $996.48 | $1,134.24 | $1,235.78 | |
Cigna
| Facility | $1,066.83 | $1,066.83 | $1,066.83 | |
Cigna
| Facility | AS | $104.84 | $104.84 | $104.84 |