| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.00 | $1,573.00 | $1,680.00 | |
Ambetter
| Facility | $193.72 | $193.72 | $411.89 | |
Anthem BCBS
| Facility | $641.38 | $1,462.05 | $3,746.12 | |
Cigna
| Facility | $5,638.00 | $5,638.00 | $5,638.00 | |
Medical Mutual of Ohio
| Facility | $5,638.00 | $5,638.00 | $5,638.00 |