Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.76 / $42.42 / $117.06	Facility		$29.76	$42.42	$117.06
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $853.83 / $853.83 / $853.83	Facility	25	$853.83	$853.83	$853.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.14 / $51.79 / $105.64	Professional		$32.14	$51.79	$105.64
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $47.91 / $94.67 / $153.47	Professional	25	$47.91	$94.67	$153.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $49.46 / $64.70	Professional		$39.28	$49.46	$64.70
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $94.02 / $94.02 / $94.02	Professional	25	$94.02	$94.02	$94.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $44.69 / $67.55	Professional		$31.19	$44.69	$67.55
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $53.15 / $53.15 / $71.64	Professional		$53.15	$53.15	$71.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.49 / $55.46 / $68.65	Facility		$45.49	$55.46	$68.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $62.40 / $106.96	Professional		$46.22	$62.40	$106.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.54 / $56.54 / $56.54	Facility		$56.54	$56.54	$56.54
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.48 / $5.48 / $5.48	Facility	AS	$5.48	$5.48	$5.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $53.15 / $76.76	Professional		$36.40	$53.15	$76.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $56.80 / $118.13	Professional		$39.93	$56.80	$118.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.57 / $37.19 / $49.90	Professional		$27.57	$37.19	$49.90
Optum Facility/Professional Professional Modifier Low / Median / High Price $47.32 / $49.81 / $66.09	Professional		$47.32	$49.81	$66.09
United Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $45.05 / $74.42	Professional		$32.63	$45.05	$74.42