| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.04 | $34.04 | $34.04 | |
Aetna
| Professional | $15.00 | $19.67 | $19.67 | |
Anthem BCBS
| Professional | $25.86 | $32.40 | $49.17 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $14.11 | $14.11 | $14.11 | |
Medical Mutual of Ohio
| Professional | $14.11 | $14.11 | $14.11 | |
Molina
| Professional | $40.00 | $50.00 | $60.00 |