Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $120.23 / $181.97	Facility		$48.98	$120.23	$181.97
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $47.86 / $107.15 / $107.15	Facility	25	$47.86	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $173.78 / $426.58	Professional		$102.33	$173.78	$426.58
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.23 / $204.17 / $489.78	Professional	25	$120.23	$204.17	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $234.42	Professional		$120.23	$165.96	$234.42
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $131.83 / $165.96 / $234.42	Professional	25	$131.83	$165.96	$234.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $234.42	Professional		$112.20	$144.54	$234.42
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	25	$125.89	$125.89	$125.89
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $173.78 / $257.04	Professional		$134.90	$173.78	$257.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $151.36 / $208.93	Facility		$123.03	$151.36	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $331.13	Professional		$154.88	$177.83	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $147.91 / $204.17	Facility		$104.71	$147.91	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $302.00	Professional		$123.03	$169.82	$302.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $151.36 / $190.55	Facility		$104.71	$151.36	$190.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $190.55 / $281.84	Professional		$125.89	$190.55	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
Optum Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $186.21 / $275.42	Professional		$89.13	$186.21	$275.42
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $251.19	Professional		$128.82	$177.83	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $131.83	Facility		$69.18	$69.18	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $245.47	Professional		$107.15	$154.88	$245.47