Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.30 / $120.21 / $437.72	Facility		$24.30	$120.21	$437.72
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $116.56 / $233.93 / $467.62	Facility	CO	$116.56	$233.93	$467.62
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $78.20 / $121.26 / $237.14	Facility	CQ	$78.20	$121.26	$237.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.84 / $25.25 / $60.54	Professional		$15.84	$25.25	$60.54
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $48.86 / $48.86 / $48.86	Professional	CO	$48.86	$48.86	$48.86
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $31.86 / $36.22 / $71.43	Professional	CQ	$31.86	$36.22	$71.43
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $22.33 / $22.33 / $32.86	Professional	CQ	$22.33	$22.33	$32.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.98 / $78.00 / $87.00	Facility		$51.98	$78.00	$87.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.37 / $21.68 / $41.60	Professional		$17.37	$21.68	$41.60
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $22.99 / $22.99 / $42.36	Facility		$22.99	$22.99	$42.36
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $26.27 / $26.27 / $38.42	Professional		$26.27	$26.27	$38.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.84 / $36.11 / $48.78	Facility		$32.84	$36.11	$48.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.84 / $39.46 / $74.06	Professional		$32.84	$39.46	$74.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $65.00 / $140.00	Facility		$41.01	$65.00	$140.00
Cigna Facility/Professional Facility Modifier CO Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CO	$34.86	$34.86	$34.86
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CQ	$34.86	$34.86	$34.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.54 / $48.66 / $111.17	Professional		$30.54	$48.66	$111.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $48.46 / $85.16 / $144.77	Facility		$48.46	$85.16	$144.77
Medical Mutual of Ohio Facility/Professional Facility Modifier CO Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CO	$34.86	$34.86	$34.86
Medical Mutual of Ohio Facility/Professional Facility Modifier CQ Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CQ	$34.86	$34.86	$34.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.26 / $37.76 / $59.58	Professional		$24.26	$37.76	$59.58
Medical Mutual of Ohio Facility/Professional Professional Modifier CQ Low / Median / High Price $27.51 / $34.56 / $44.16	Professional	CQ	$27.51	$34.56	$44.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.11 / $32.80 / $48.62	Professional		$24.11	$32.80	$48.62
United Facility/Professional Professional Modifier Low / Median / High Price $23.48 / $33.65 / $44.10	Professional		$23.48	$33.65	$44.10