| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $758.58 | $891.25 | $1,288.25 | |
Cigna
| Facility | $3,981.07 | $3,981.07 | $3,981.07 | |
Medical Mutual of Ohio
| Facility | $3,981.07 | $3,981.07 | $3,981.07 | |
Molina
| Facility | $5,248.07 | $8,912.51 | $14,454.40 | |
SummaCare
| Facility | $1,479.11 | $1,479.11 | $1,479.11 |