| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $872.82 | $872.82 | $2,600.00 | |
CareSource
| Facility | $984.37 | $1,100.30 | $1,198.80 | |
Cigna
| Facility | $1,061.17 | $1,061.17 | $1,061.17 | |
Cigna
| Facility | AS | $104.13 | $104.13 | $104.13 |