Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.66 / $83.15 / $173.54	Facility		$54.66	$83.15	$173.54
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $46.69 / $70.06 / $121.63	Facility	25	$46.69	$70.06	$121.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.25 / $102.93 / $217.03	Professional		$64.25	$102.93	$217.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.14 / $117.69 / $266.23	Professional	25	$60.14	$117.69	$266.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $709.80 / $709.80	Professional	50	$94.50	$709.80	$709.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.52 / $120.16 / $164.64	Professional		$89.52	$120.16	$164.64
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $91.58 / $120.16 / $180.24	Professional	25	$91.58	$120.16	$180.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.98 / $91.60 / $151.38	Professional		$59.98	$91.60	$151.38
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $91.58 / $120.16 / $157.41	Professional		$91.58	$120.16	$157.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.07 / $108.98 / $137.37	Facility		$91.07	$108.98	$137.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.16 / $156.21 / $244.65	Professional		$120.16	$156.21	$244.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $129.72 / $180.00	Facility		$105.00	$129.72	$180.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.75 / $123.00 / $196.78	Professional		$77.75	$123.00	$196.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $129.72 / $205.00	Facility		$100.00	$129.72	$205.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $95.34 / $142.47 / $198.70	Professional		$95.34	$142.47	$198.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.68 / $147.18 / $204.09	Professional		$105.68	$147.18	$204.09
Optum Facility/Professional Professional Modifier Low / Median / High Price $100.24 / $128.43 / $189.75	Professional		$100.24	$128.43	$189.75
United Facility/Professional Professional Modifier Low / Median / High Price $75.70 / $114.62 / $179.37	Professional		$75.70	$114.62	$179.37