| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $81.80 | $4,723.00 | $11,627.00 | |
CareSource
| Facility | $80.25 | $96.30 | $119.19 | |
Cigna
| Facility | $21,571.00 | $21,571.00 | $21,571.00 | |
Medical Mutual of Ohio
| Facility | $96.68 | $96.68 | $96.68 | |
Medical Mutual of Ohio
| Facility | AS | $9.47 | $9.47 | $9.47 |
United
| Facility | $444.00 | $965.00 | $2,914.00 |