| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $125.89 | $213.80 | |
Aetna
| Professional | $114.82 | $120.23 | $123.03 | |
Anthem BCBS
| Professional | $44.67 | $125.89 | $138.04 | |
Medical Mutual of Ohio
| Facility | $54.95 | $123.03 | $691.83 |