Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.67 / $235.39 / $1,500.00	Facility		$58.67	$235.39	$1,500.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $469.20 / $819.85 / $1,841.26	Facility	25	$469.20	$819.85	$1,841.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $65.70 / $146.41	Professional		$47.50	$65.70	$146.41
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.19 / $151.09 / $304.00	Professional	25	$60.19	$151.09	$304.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.37 / $102.21 / $252.00	Professional		$65.37	$102.21	$252.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.41 / $94.37 / $161.78	Professional	25	$67.41	$94.37	$161.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.90 / $84.17 / $148.49	Professional		$62.90	$84.17	$148.49
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $65.89 / $75.06 / $94.37	Professional		$65.89	$75.06	$94.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.41 / $77.52 / $101.12	Facility		$67.41	$77.52	$101.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.94 / $87.63 / $149.41	Professional		$67.94	$87.63	$149.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.02 / $82.02 / $661.00	Facility		$82.02	$82.02	$661.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.65 / $84.69 / $140.69	Professional		$59.65	$84.69	$140.69
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $82.02 / $618.10 / $1,073.98	Facility		$82.02	$618.10	$1,073.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $95.27 / $198.62	Professional		$67.40	$95.27	$198.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $80.61 / $108.13	Professional		$55.15	$80.61	$108.13
Optum Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $96.40 / $279.64	Professional		$68.56	$96.40	$279.64
United Facility/Professional Professional Modifier Low / Median / High Price $53.12 / $76.93 / $138.27	Professional		$53.12	$76.93	$138.27