| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.55 | $2,218.00 | $9,516.00 | |
Anthem BCBS
| Facility | $1,145.00 | $2,722.00 | $8,800.00 | |
CareSource
| Facility | $56.34 | $65.59 | $82.05 | |
Cigna
| Facility | $21,571.00 | $21,571.00 | $21,571.00 | |
Medical Mutual of Ohio
| Facility | $1,406.25 | $1,406.25 | $1,406.25 | |
United
| Facility | $1,020.00 | $1,940.00 | $4,132.00 |