| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.55 | $111.70 | $310.00 | |
Aetna
| Professional | $94.55 | $105.64 | $131.18 | |
Anthem BCBS
| Professional | $114.14 | $127.97 | $363.37 | |
Cigna
| Professional | $107.43 | $107.43 | $107.43 | |
Medical Mutual of Ohio
| Professional | $107.43 | $107.43 | $107.43 | |
Molina
| Professional | $109.84 | $148.65 | $208.79 | |
United
| Professional | $111.36 | $148.74 | $225.03 |