| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $40,249.60 | $40,249.60 | $40,249.60 | |
Cigna
| Professional | $2,350.88 | $2,484.69 | $2,976.95 | |
Medical Mutual of Ohio
| Professional | $85.14 | $136.84 | $592.12 | |
Molina
| Professional | $40.00 | $50.00 | $60.00 |