Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.10 / $155.07 / $397.36	Facility		$36.10	$155.07	$397.36
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $66.75 / $201.69 / $665.52	Facility	CO	$66.75	$201.69	$665.52
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $61.92 / $121.10 / $491.52	Facility	CQ	$61.92	$121.10	$491.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.04 / $22.85 / $104.97	Professional		$14.04	$22.85	$104.97
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $90.00 / $90.00 / $90.00	Professional	CO	$90.00	$90.00	$90.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $21.22 / $50.53 / $120.12	Professional	CQ	$21.22	$50.53	$120.12
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $18.73 / $18.73 / $18.73	Professional	CQ	$18.73	$18.73	$18.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $77.00 / $87.00	Facility		$41.38	$77.00	$87.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.64 / $21.54 / $36.82	Professional		$16.64	$21.54	$36.82
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $19.29 / $19.29 / $35.54	Facility		$19.29	$19.29	$35.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $22.05 / $22.05 / $36.10	Professional		$22.05	$22.05	$36.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $30.32 / $40.93	Facility		$27.54	$30.32	$40.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $33.07 / $62.56	Professional		$27.56	$33.07	$62.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.54 / $65.00 / $140.00	Facility		$36.54	$65.00	$140.00
Cigna Facility/Professional Facility Modifier CO Low / Median / High Price $27.88 / $27.88 / $27.88	Facility	CO	$27.88	$27.88	$27.88
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $27.88 / $27.88 / $27.88	Facility	CQ	$27.88	$27.88	$27.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.17 / $42.85 / $111.17	Professional		$24.17	$42.85	$111.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $45.83 / $82.31 / $136.27	Facility		$45.83	$82.31	$136.27
Medical Mutual of Ohio Facility/Professional Facility Modifier CO Low / Median / High Price $27.88 / $27.88 / $27.88	Facility	CO	$27.88	$27.88	$27.88
Medical Mutual of Ohio Facility/Professional Facility Modifier CQ Low / Median / High Price $27.88 / $27.88 / $27.88	Facility	CQ	$27.88	$27.88	$27.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $20.02 / $34.72 / $54.23	Professional		$20.02	$34.72	$54.23
Medical Mutual of Ohio Facility/Professional Professional Modifier CO Low / Median / High Price $20.11 / $35.76 / $35.76	Professional	CO	$20.11	$35.76	$35.76
Medical Mutual of Ohio Facility/Professional Professional Modifier CQ Low / Median / High Price $17.55 / $22.72 / $34.00	Professional	CQ	$17.55	$22.72	$34.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.67 / $20.80 / $26.51	Professional		$17.67	$20.80	$26.51
United Facility/Professional Professional Modifier Low / Median / High Price $20.73 / $26.69 / $39.88	Professional		$20.73	$26.69	$39.88