Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.52 / $140.66 / $272.57	Facility		$59.52	$140.66	$272.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.62 / $68.53 / $147.00	Professional		$50.62	$68.53	$147.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $119.16 / $119.16 / $119.16	Professional	25	$119.16	$119.16	$119.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $161.00 / $182.00	Facility		$142.00	$161.00	$182.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.31 / $78.94 / $134.19	Professional		$58.31	$78.94	$134.19
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $65.72 / $65.72 / $121.11	Facility		$65.72	$65.72	$121.11
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $65.72 / $75.09 / $122.98	Professional		$65.72	$75.09	$122.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.69 / $103.27 / $139.43	Facility		$93.69	$103.27	$139.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.88 / $112.66 / $213.23	Professional		$93.88	$112.66	$213.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $140.00	Facility		$65.00	$65.00	$140.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.33 / $93.88 / $143.32	Professional		$67.33	$93.88	$143.32
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $104.06 / $197.56 / $357.55	Facility		$104.06	$197.56	$357.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.33 / $112.80 / $163.82	Professional		$67.33	$112.80	$163.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.03 / $104.04 / $144.52	Professional		$80.03	$104.04	$144.52
United Facility/Professional Professional Modifier Low / Median / High Price $58.68 / $75.75 / $109.57	Professional		$58.68	$75.75	$109.57