Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.45 / $88.62 / $316.55	Facility		$66.45	$88.62	$316.55
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $784.82 / $784.82 / $2,629.08	Facility	25	$784.82	$784.82	$2,629.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $110.51 / $263.85	Professional		$75.31	$110.51	$263.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.16 / $134.50 / $258.24	Professional		$105.16	$134.50	$258.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.30 / $116.80 / $175.82	Professional		$86.30	$116.80	$175.82
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $107.60 / $118.36 / $172.16	Professional		$107.60	$118.36	$172.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $105.76 / $129.12 / $159.81	Facility		$105.76	$129.12	$159.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.60 / $145.26 / $248.99	Professional		$107.60	$145.26	$248.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.88 / $129.88 / $129.88	Facility		$129.88	$129.88	$129.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.39 / $133.41 / $199.00	Professional		$98.39	$133.41	$199.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $101.59 / $139.15 / $258.00	Professional		$101.59	$139.15	$258.00
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 $109.14 / $114.88 / $153.87	Professional		$109.14	$114.88	$153.87
United Facility/Professional Professional Modifier Low / Median / High Price $87.19 / $119.89 / $184.93	Professional		$87.19	$119.89	$184.93