| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $256.70 | $1,177.48 | $1,491.06 | |
Cigna
| Professional | 26 | $48.29 | $201.47 | $255.12 |
Cigna
| Professional | TC | $189.86 | $976.02 | $1,235.94 |
Medical Mutual of Ohio
| Professional | $80.98 | $278.82 | $362.07 |