Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.32 / $112.91 / $309.99	Facility		$22.32	$112.91	$309.99
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $68.47 / $142.88 / $397.62	Facility	CQ	$68.47	$142.88	$397.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.84 / $23.85 / $70.59	Professional		$15.84	$23.85	$70.59
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $22.84 / $31.64 / $55.04	Professional	CQ	$22.84	$31.64	$55.04
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $25.75 / $25.75 / $25.75	Professional	CQ	$25.75	$25.75	$25.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.24 / $78.00 / $87.00	Facility		$45.24	$78.00	$87.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $22.00 / $39.78	Professional		$16.98	$22.00	$39.78
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $21.46 / $21.46 / $39.54	Facility		$21.46	$21.46	$39.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $24.52 / $24.52 / $35.86	Professional		$24.52	$24.52	$35.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.65 / $33.72 / $45.53	Facility		$30.65	$33.72	$45.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $36.78 / $69.54	Professional		$30.65	$36.78	$69.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.13 / $65.00 / $140.00	Facility		$38.13	$65.00	$140.00
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $32.00 / $32.00 / $32.00	Facility	CQ	$32.00	$32.00	$32.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $46.33 / $111.17	Professional		$27.72	$46.33	$111.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $44.57 / $82.88 / $133.66	Facility		$44.57	$82.88	$133.66
Medical Mutual of Ohio Facility/Professional Facility Modifier CQ Low / Median / High Price $32.00 / $32.00 / $32.00	Facility	CQ	$32.00	$32.00	$32.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $22.28 / $36.78 / $55.85	Professional		$22.28	$36.78	$55.85
Medical Mutual of Ohio Facility/Professional Professional Modifier CQ Low / Median / High Price $22.17 / $29.22 / $45.90	Professional	CQ	$22.17	$29.22	$45.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.25 / $35.58 / $49.73	Professional		$24.25	$35.58	$49.73
United Facility/Professional Professional Modifier Low / Median / High Price $22.28 / $30.68 / $41.77	Professional		$22.28	$30.68	$41.77