| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.30 | $390.29 | $634.75 | |
Aetna
| Professional | $17.30 | $50.74 | $494.96 | |
Anthem BCBS
| Professional | $27.78 | $115.88 | $392.09 | |
CareSource
| Facility | $16.67 | $16.80 | $23.53 | |
Cigna
| Professional | $15.96 | $89.33 | $562.73 | |
Medical Mutual of Ohio
| Professional | $15.96 | $130.87 | $582.26 | |
Molina
| Professional | $305.84 | $426.97 | $624.44 | |
United
| Professional | $58.26 | $280.38 | $384.37 |