| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,580.84 | $4,000.00 | $13,480.00 | |
Aetna
| Professional | $1,609.27 | $4,000.00 | $4,000.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Medical Mutual of Ohio
| Facility | $318.52 | $1,651.04 | $4,273.75 |