Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $75.51 / $125.00	Professional		$42.00	$75.51	$125.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $76.23 / $97.52 / $154.85	Professional	25	$76.23	$97.52	$154.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.92 / $78.59 / $104.73	Professional		$74.92	$78.59	$104.73
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $57.10 / $80.56 / $104.73	Professional	25	$57.10	$80.56	$104.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.37 / $55.00 / $113.19	Professional		$28.37	$55.00	$113.19
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $80.56 / $80.56 / $80.56	Professional		$80.56	$80.56	$80.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.04 / $55.66 / $68.89	Facility		$46.04	$55.66	$68.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $86.20 / $108.76	Professional		$78.59	$86.20	$108.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.94 / $79.94 / $79.94	Facility		$79.94	$79.94	$79.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.74 / $71.06 / $140.46	Professional		$41.74	$71.06	$140.46
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43.78 / $76.53 / $137.60	Professional		$43.78	$76.53	$137.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.19 / $112.72 / $155.60	Professional		$78.19	$112.72	$155.60
United Facility/Professional Professional Modifier Low / Median / High Price $47.38 / $76.16 / $138.01	Professional		$47.38	$76.16	$138.01