Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.88 / $120.98 / $821.02	Facility		$83.88	$120.98	$821.02
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $612.47 / $780.14 / $921.60	Facility	25	$612.47	$780.14	$921.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.64 / $142.85 / $316.00	Professional		$89.64	$142.85	$316.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.01 / $125.14 / $190.17	Professional		$119.01	$125.14	$190.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.87 / $139.81 / $212.17	Professional		$102.87	$139.81	$212.17
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $134.96 / $158.27 / $196.30	Professional		$134.96	$158.27	$196.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.67 / $147.22 / $182.23	Facility		$120.67	$147.22	$182.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $122.69 / $165.63 / $283.95	Professional		$122.69	$165.63	$283.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.03 / $149.03 / $149.03	Facility		$149.03	$149.03	$149.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.01 / $159.41 / $245.38	Professional		$119.01	$159.41	$245.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.51 / $166.15 / $295.67	Professional		$123.51	$166.15	$295.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.46 / $141.00 / $193.93	Professional		$108.46	$141.00	$193.93
Optum Facility/Professional Professional Modifier Low / Median / High Price $123.95 / $130.47 / $175.45	Professional		$123.95	$130.47	$175.45
United Facility/Professional Professional Modifier Low / Median / High Price $108.83 / $144.41 / $240.68	Professional		$108.83	$144.41	$240.68