| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.08 | $94.08 | $116.89 | |
Aetna
| Professional | $88.52 | $102.33 | $124.66 | |
Cigna
| Facility | $138.66 | $138.66 | $138.66 | |
Cigna
| Professional | $104.45 | $104.45 | $104.45 | |
Medical Mutual of Ohio
| Facility | $138.66 | $138.66 | $138.66 | |
Medical Mutual of Ohio
| Professional | $104.45 | $104.45 | $104.45 | |
Molina
| Professional | $82.48 | $119.52 | $161.23 | |
United
| Professional | $102.50 | $144.11 | $218.34 |