| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $897.75 | $897.75 | $1,600.00 | |
CareSource
| Facility | $927.97 | $1,009.87 | $1,100.28 | |
Cigna
| Facility | $1,000.43 | $1,000.43 | $1,000.43 | |
Cigna
| Facility | AS | $99.92 | $99.92 | $99.92 |