| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.52 | $2,547.00 | $10,268.00 | |
CareSource
| Facility | $66.37 | $70.45 | $79.64 | |
Cigna
| Facility | $93.73 | $93.73 | $93.73 | |
Medical Mutual of Ohio
| Facility | $93.73 | $93.73 | $93.73 |