Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.48 / $70.52 / $205.26	Facility		$51.48	$70.52	$205.26
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $47.71 / $48.81 / $160.41	Facility	25	$47.71	$48.81	$160.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.07 / $95.54 / $189.00	Professional		$62.07	$95.54	$189.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $69.81 / $118.60 / $275.00	Professional	25	$69.81	$118.60	$275.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.43 / $104.54 / $156.81	Professional		$77.43	$104.54	$156.81
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $79.98 / $104.54 / $146.36	Professional	25	$79.98	$104.54	$146.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.20 / $105.76 / $164.63	Professional		$75.20	$105.76	$164.63
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $97.74 / $120.22 / $136.94	Professional		$97.74	$120.22	$136.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.01 / $92.14 / $116.15	Facility		$77.01	$92.14	$116.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.54 / $135.90 / $213.29	Professional		$104.54	$135.90	$213.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $110.00 / $180.00	Facility		$105.00	$110.00	$180.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.77 / $112.28 / $182.87	Professional		$76.77	$112.28	$182.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $120.00 / $205.00	Facility		$105.00	$120.00	$205.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $85.37 / $127.21 / $189.00	Professional		$85.37	$127.21	$189.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.19 / $146.80 / $204.09	Professional		$105.19	$146.80	$204.09
Optum Facility/Professional Professional Modifier Low / Median / High Price $88.13 / $120.78 / $178.47	Professional		$88.13	$120.78	$178.47
United Facility/Professional Professional Modifier Low / Median / High Price $83.95 / $115.14 / $184.29	Professional		$83.95	$115.14	$184.29