Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.36 / $47.71 / $98.23	Facility		$31.36	$47.71	$98.23
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $47.71 / $48.81 / $56.71	Facility	25	$47.71	$48.81	$56.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.89 / $61.88 / $114.92	Professional		$36.89	$61.88	$114.92
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $49.78 / $87.52 / $193.56	Professional	25	$49.78	$87.52	$193.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.21 / $65.78 / $103.23	Professional		$44.21	$65.78	$103.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $53.05 / $66.59 / $84.92	Professional	25	$53.05	$66.59	$84.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $69.27 / $108.64	Professional		$48.40	$69.27	$108.64
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $66.59 / $70.73 / $87.25	Professional		$66.59	$70.73	$87.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.97 / $52.61 / $66.31	Facility		$43.97	$52.61	$66.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.59 / $86.58 / $130.12	Professional		$66.59	$86.58	$130.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $110.00 / $180.00	Facility		$62.64	$110.00	$180.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.82 / $70.73 / $118.25	Professional		$46.82	$70.73	$118.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $110.00 / $205.00	Facility		$62.64	$110.00	$205.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $48.64 / $76.59 / $118.25	Professional		$48.64	$76.59	$118.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.54 / $73.09 / $102.02	Professional		$52.54	$73.09	$102.02
Optum Facility/Professional Professional Modifier Low / Median / High Price $58.83 / $83.95 / $120.92	Professional		$58.83	$83.95	$120.92
United Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $83.09 / $132.61	Professional		$57.92	$83.09	$132.61