| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.44 | $2,818.38 | $10,715.19 | |
CareSource
| Facility | $323.59 | $323.59 | $380.19 | |
Cigna
| Facility | $21,379.62 | $21,379.62 | $21,379.62 | |
Medical Mutual of Ohio
| Facility | $21,379.62 | $21,379.62 | $21,379.62 | |
SummaCare
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $457.09 | $954.99 | $3,019.95 |