| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $2,682.23 | $2,682.23 | $2,682.23 | |
Medical Mutual of Ohio
| Professional | $2,682.23 | $2,682.23 | $2,682.23 | |
Molina
| Professional | $30.00 | $50.00 | $60.00 |