| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $495.00 | $495.00 | $495.00 | |
Ambetter
| Facility | $1,002.12 | $1,002.12 | $1,002.12 | |
Cigna
| Facility | $1,000.00 | $1,000.00 | $1,000.00 | |
Medical Mutual of Ohio
| Facility | $1,000.00 | $1,000.00 | $1,000.00 |