| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $158.49 | $229.09 | $512.86 |
Cigna
| Facility | 26 | $36.31 | $169.82 | $245.47 |
Medical Mutual of Ohio
| Facility | 26 | $36.31 | $169.82 | $245.47 |
SummaCare
| Facility | 26 | $676.08 | $676.08 | $676.08 |