Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $232.59 / $1,166.68 / $4,781.00	Facility		$232.59	$1,166.68	$4,781.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,898.90 / $4,653.00 / $5,033.00	Facility	25	$1,898.90	$4,653.00	$5,033.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.23 / $235.13 / $525.82	Professional		$172.23	$235.13	$525.82
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $172.15 / $315.05 / $1,015.59	Professional	25	$172.15	$315.05	$1,015.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.83 / $273.87 / $485.06	Professional		$200.83	$273.87	$485.06
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $195.62 / $248.54 / $485.06	Professional	25	$195.62	$248.54	$485.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.35 / $262.74 / $423.42	Professional		$186.35	$262.74	$423.42
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $222.32 / $252.64 / $323.38	Professional		$222.32	$252.64	$323.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $202.11 / $238.49 / $303.17	Facility		$202.11	$238.49	$303.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $256.62 / $333.61 / $526.76	Professional		$256.62	$333.61	$526.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $286.33 / $286.33 / $286.33	Facility		$286.33	$286.33	$286.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.49 / $293.05 / $513.24	Professional		$206.49	$293.05	$513.24
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $286.33 / $1,009.61 / $3,543.58	Facility		$286.33	$1,009.61	$3,543.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $214.56 / $305.38 / $569.58	Professional		$214.56	$305.38	$569.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $212.61 / $292.35 / $412.88	Professional		$212.61	$292.35	$412.88
United Facility/Professional Facility Modifier Low / Median / High Price $2,305.69 / $2,305.69 / $2,362.40	Facility		$2,305.69	$2,305.69	$2,362.40
United Facility/Professional Professional Modifier Low / Median / High Price $225.08 / $313.23 / $524.53	Professional		$225.08	$313.23	$524.53