Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.24 / $82.28 / $811.25	Facility		$53.24	$82.28	$811.25
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $490.64 / $704.75 / $951.66	Facility	25	$490.64	$704.75	$951.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.85 / $96.17 / $202.73	Professional		$54.85	$96.17	$202.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.08 / $89.53 / $120.67	Professional		$75.08	$89.53	$120.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.65 / $86.92 / $132.21	Professional		$66.65	$86.92	$132.21
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $120.67 / $120.67 / $124.56	Professional		$120.67	$120.67	$124.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.47 / $93.42 / $115.63	Facility		$76.47	$93.42	$115.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $105.10 / $179.93	Professional		$77.84	$105.10	$179.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.44 / $94.44 / $94.44	Facility		$94.44	$94.44	$94.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.62 / $107.05 / $177.52	Professional		$78.62	$107.05	$177.52
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $80.06 / $119.60 / $209.29	Professional		$80.06	$119.60	$209.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.97 / $106.45 / $144.77	Professional		$80.97	$106.45	$144.77
Optum Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $83.36 / $111.33	Professional		$79.19	$83.36	$111.33
United Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $105.10 / $173.76	Professional		$77.95	$105.10	$173.76