| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.22 | $46.31 | $195.00 | |
Aetna
| Professional | $39.22 | $47.58 | $60.95 | |
Anthem BCBS
| Professional | $39.20 | $55.22 | $81.73 | |
CareSource
| Facility | $35.04 | $43.81 | $63.09 | |
Cigna
| Professional | $47.48 | $60.30 | $99.66 | |
Medical Mutual of Ohio
| Professional | $47.48 | $61.12 | $97.51 | |
Molina
| Professional | $52.98 | $71.16 | $101.99 | |
United
| Professional | $53.18 | $73.86 | $108.60 |