| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $345.04 | $2,113.00 | $9,534.00 | |
CareSource
| Facility | $246.61 | $295.93 | $369.92 | |
Cigna
| Facility | $21,571.00 | $21,571.00 | $21,571.00 | |
Medical Mutual of Ohio
| Facility | $293.27 | $1,705.91 | $3,017.53 | |
Medical Mutual of Ohio
| Facility | 62 | $179.89 | $179.89 | $179.89 |
Medical Mutual of Ohio
| Facility | AS | $28.78 | $28.78 | $28.78 |
United
| Facility | $444.00 | $965.00 | $2,914.00 |