| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $641.38 | $1,463.16 | $3,775.00 | |
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 |
Specialty Services-Other Specialty Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $641.38 | $1,463.16 | $3,775.00 | |
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 |