Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.66 / $66.20 / $188.00	Facility		$49.66	$66.20	$188.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $431.28 / $612.47 / $2,314.94	Facility	25	$431.28	$612.47	$2,314.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $80.47 / $171.04	Professional		$52.12	$80.47	$171.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $78.37 / $116.42	Professional		$72.56	$78.37	$116.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $70.81 / $107.89	Professional		$52.49	$70.81	$107.89
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $74.63 / $82.09 / $119.41	Professional		$74.63	$82.09	$119.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.43 / $89.56 / $110.84	Facility		$73.43	$89.56	$110.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.63 / $100.75 / $172.74	Professional		$74.63	$100.75	$172.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.96 / $89.96 / $89.96	Facility		$89.96	$89.96	$89.96
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.72 / $8.72 / $8.72	Facility	AS	$8.72	$8.72	$8.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.41 / $90.94 / $135.07	Professional		$66.41	$90.94	$135.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,103.49 / $1,103.49 / $1,103.49	Facility		$1,103.49	$1,103.49	$1,103.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $95.87 / $181.57	Professional		$67.00	$95.87	$181.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $106.46 / $144.77	Professional		$82.26	$106.46	$144.77
Optum Facility/Professional Professional Modifier Low / Median / High Price $75.34 / $79.30 / $106.72	Professional		$75.34	$79.30	$106.72
United Facility/Professional Professional Modifier Low / Median / High Price $58.90 / $80.63 / $127.95	Professional		$58.90	$80.63	$127.95