| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.29 | $184.16 | $320.00 | |
CareSource
| Facility | $95.14 | $95.14 | $138.54 | |
Medical Mutual of Ohio
| Facility | $409.51 | $409.51 | $4,247.18 | |
United
| Facility | $1,480.00 | $3,086.00 | $6,792.00 |