| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $947.30 | $1,400.00 | $2,300.00 | |
CareSource
| Facility | $985.24 | $1,122.34 | $1,222.80 | |
Cigna
| Facility | $1,051.52 | $1,051.52 | $1,051.52 | |
Cigna
| Facility | AS | $102.94 | $102.94 | $102.94 |