| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.39 | $10.39 | $10.39 | |
Aetna
| Professional | $6.00 | $6.00 | $6.00 | |
Anthem BCBS
| Professional | $15.00 | $16.20 | $24.58 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $15.24 | $15.24 | $16.00 | |
Medical Mutual of Ohio
| Professional | $15.24 | $15.24 | $16.00 | |
Molina
| Professional | $40.00 | $50.00 | $60.00 |