| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $982.61 | $982.61 | $1,400.00 | |
CareSource
| Facility | $1,119.35 | $1,296.55 | $1,412.61 | |
Cigna
| Facility | $1,196.68 | $1,196.68 | $1,196.68 | |
Cigna
| Facility | AS | $119.00 | $119.00 | $119.00 |