| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.00 | $1.00 | $2.29 | |
Aetna
| Professional | $1.00 | $1.00 | $1.00 | |
Anthem BCBS
| Professional | $141.25 | $173.78 | $281.84 | |
Cigna
| Professional | $309.03 | $309.03 | $309.03 | |
Medical Mutual of Ohio
| Professional | $309.03 | $309.03 | $309.03 | |
Molina
| Professional | $30.20 | $50.12 | $60.26 | |
SummaCare
| Professional | $60.26 | $60.26 | $75.86 |