| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $43.65 | $58.88 | $58.88 | |
Aetna
| Professional | $40.74 | $47.86 | $58.88 | |
Cigna
| Facility | $85.11 | $85.11 | $85.11 | |
Cigna
| Professional | $48.98 | $48.98 | $48.98 | |
Medical Mutual of Ohio
| Facility | $75.86 | $75.86 | $75.86 | |
Medical Mutual of Ohio
| Professional | $48.98 | $48.98 | $48.98 | |
Molina
| Professional | $32.36 | $33.11 | $33.11 | |
SummaCare
| Professional | $54.95 | $61.66 | $128.82 | |
United
| Professional | $45.71 | $61.66 | $95.50 |