| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.00 | $126.00 | $252.00 | |
Ambetter
| Facility | $29.41 | $29.41 | $29.41 | |
Cigna
| Facility | $19.00 | $25.00 | $35.00 | |
Medical Mutual of Ohio
| Facility | $19.00 | $19.00 | $25.00 |
Clinic-Other Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.00 | $126.00 | $252.00 | |
Ambetter
| Facility | $29.41 | $29.41 | $29.41 | |
Cigna
| Facility | $19.00 | $25.00 | $35.00 | |
Medical Mutual of Ohio
| Facility | $19.00 | $19.00 | $25.00 |