| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $892.87 | $892.87 | $3,550.00 | |
CareSource
| Facility | $1,014.88 | $1,130.41 | $1,231.58 | |
Cigna
| Facility | $1,094.69 | $1,094.69 | $1,094.69 | |
Cigna
| Facility | AS | $108.38 | $108.38 | $108.38 |