| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,174.90 | $2,754.23 | $8,709.64 | |
Aetna
| Professional | $3,801.89 | $5,128.61 | $15,848.93 | |
Cigna
| Professional | $3,467.37 | $3,467.37 | $3,467.37 | |
Medical Mutual of Ohio
| Facility | $97.72 | $1,412.54 | $2,511.89 | |
Medical Mutual of Ohio
| Professional | $3,467.37 | $3,467.37 | $3,467.37 |