| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.76 | $71.76 | $89.32 | |
Aetna
| Professional | $67.75 | $77.94 | $95.27 | |
Cigna
| Facility | $105.82 | $105.82 | $105.82 | |
Cigna
| Professional | $79.45 | $79.45 | $79.45 | |
Medical Mutual of Ohio
| Facility | $105.82 | $105.82 | $105.82 | |
Medical Mutual of Ohio
| Professional | $79.45 | $79.45 | $79.45 | |
Molina
| Professional | $54.98 | $79.68 | $107.49 | |
United
| Professional | $77.78 | $110.11 | $168.48 |