| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.70 | $93.33 | $1,258.93 | |
CareSource
| Facility | $44.67 | $44.67 | $44.67 | |
Medical Mutual of Ohio
| Facility | $79.43 | $1,949.84 | $1,949.84 | |
United
| Facility | $457.09 | $954.99 | $3,715.35 |