| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.63 | $323.67 | $4,038.24 | |
CareSource
| Facility | $92.78 | $92.78 | $135.09 | |
Medical Mutual of Ohio
| Facility | $254.40 | $254.40 | $1,806.34 | |
United
| Facility | $444.00 | $979.00 | $3,218.00 |