Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $74.13 / $158.49	Professional		$38.90	$74.13	$158.49
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $75.86 / $114.82 / $186.21	Professional	25	$75.86	$114.82	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $81.28	Professional		$72.44	$79.43	$81.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $66.07 / $131.83	Professional		$40.74	$66.07	$131.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $104.71	Professional		$75.86	$75.86	$104.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $43.65 / $56.23	Facility		$33.88	$43.65	$56.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $79.43 / $104.71	Professional		$74.13	$79.43	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $69.18 / $125.89	Professional		$37.15	$69.18	$125.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $69.18 / $131.83	Professional		$37.15	$69.18	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $32.36 / $33.11	Professional		$16.60	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $83.18 / $120.23	Professional		$38.90	$83.18	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $40.74	Facility		$40.74	$40.74	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $54.95 / $95.50	Professional		$35.48	$54.95	$95.50