Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $100.00 / $309.03	Facility		$67.61	$100.00	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $213.80	Professional		$67.61	$100.00	$213.80
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	25	$407.38	$407.38	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $83.18 / $112.20	Professional		$63.10	$83.18	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $162.18	Professional		$72.44	$104.71	$162.18
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $138.04 / $186.21	Professional		$89.13	$138.04	$186.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $91.20 / $125.89	Facility		$69.18	$91.20	$125.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $141.25	Professional		$83.18	$112.20	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $97.72 / $169.82	Professional		$66.07	$97.72	$169.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $154.88	Professional		$66.07	$91.20	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $69.18	Professional		$32.36	$33.11	$69.18
Optum Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $190.55	Professional		$72.44	$100.00	$190.55
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $177.83	Professional		$85.11	$123.03	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $173.78	Professional		$70.79	$97.72	$173.78