Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $147.91 / $338.84	Facility		$114.82	$147.91	$338.84
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Facility	25	$1,148.15	$1,148.15	$1,148.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $181.97 / $398.11	Professional		$125.89	$181.97	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $239.88	Professional		$138.04	$169.82	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $199.53 / $288.40	Professional		$147.91	$199.53	$288.40
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $199.53 / $309.03	Professional		$154.88	$199.53	$309.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $208.93 / $281.84	Facility		$162.18	$208.93	$281.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $389.05	Professional		$169.82	$223.87	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $223.87 / $371.54	Professional		$165.96	$223.87	$371.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $218.78 / $363.08	Professional		$147.91	$218.78	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Optum Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $218.78	Professional		$165.96	$173.78	$218.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $309.03	Professional		$169.82	$213.80	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $331.13	Professional		$154.88	$208.93	$331.13