| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $715.00 | $2,929.00 | $9,870.71 | |
Aetna
| Professional | $137.47 | $2,929.00 | $2,929.00 | |
Cigna
| Professional | $165.00 | $165.00 | $165.00 | |
Medical Mutual of Ohio
| Facility | $339.61 | $1,174.74 | $2,491.61 | |
Medical Mutual of Ohio
| Professional | $165.00 | $165.00 | $165.00 |