Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.35 / $113.90 / $188.00	Professional		$63.35	$113.90	$188.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $31.36 / $138.03 / $209.47	Professional	25	$31.36	$138.03	$209.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.44 / $114.45 / $160.22	Professional		$106.44	$114.45	$160.22
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $86.20 / $114.45 / $148.79	Professional	25	$86.20	$114.45	$148.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $80.50 / $163.30	Professional		$46.35	$80.50	$163.30
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $114.45 / $114.45 / $114.45	Professional		$114.45	$114.45	$114.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.52 / $83.95 / $103.91	Facility		$69.52	$83.95	$103.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.79 / $122.46 / $154.51	Professional		$111.79	$122.46	$154.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.68 / $120.68 / $120.68	Facility		$120.68	$120.68	$120.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.31 / $103.55 / $207.15	Professional		$60.31	$103.55	$207.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.95 / $115.33 / $211.40	Professional		$69.95	$115.33	$211.40
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 $78.05 / $108.90 / $197.36	Professional		$78.05	$108.90	$197.36