| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $354.27 | $6,815.00 | $11,581.00 | |
CareSource
| Facility | $198.70 | $275.83 | $401.68 | |
Medical Mutual of Ohio
| Facility | $9,046.71 | $9,078.29 | $16,488.36 | |
United
| Facility | $467.00 | $1,078.00 | $5,803.00 |