| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $368.94 | $709.28 | $1,456.69 | |
Cigna
| Facility | $1,349.28 | $1,349.28 | $1,349.28 | |
Medical Mutual of Ohio
| Facility | $1,349.28 | $1,349.28 | $1,349.28 |
Level 4 Imaging without Contrast
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $368.94 | $709.28 | $1,456.69 | |
Cigna
| Facility | $1,349.28 | $1,349.28 | $1,349.28 | |
Medical Mutual of Ohio
| Facility | $1,349.28 | $1,349.28 | $1,349.28 |