Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.71 / $122.49 / $147.38	Facility		$109.71	$122.49	$147.38
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $642.07 / $642.07 / $642.07	Facility	25	$642.07	$642.07	$642.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.17 / $106.40 / $286.13	Professional		$86.17	$106.40	$286.13
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $93.40 / $362.70 / $1,255.60	Professional	25	$93.40	$362.70	$1,255.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.01 / $136.97 / $242.42	Professional		$101.01	$136.97	$242.42
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $101.01 / $141.41 / $242.42	Professional	25	$101.01	$141.41	$242.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.91 / $125.12 / $192.84	Professional		$92.91	$125.12	$192.84
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $101.02 / $112.51 / $161.62	Professional		$101.02	$112.51	$161.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.01 / $119.19 / $151.52	Facility		$101.01	$119.19	$151.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.51 / $146.26 / $232.33	Professional		$112.51	$146.26	$232.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.15 / $143.15 / $143.15	Facility		$143.15	$143.15	$143.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.26 / $136.13 / $232.33	Professional		$101.26	$136.13	$232.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $143.15 / $143.15 / $785.32	Facility		$143.15	$143.15	$785.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $104.63 / $141.41 / $240.76	Professional		$104.63	$141.41	$240.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.03 / $109.07 / $155.41	Professional		$80.03	$109.07	$155.41
United Facility/Professional Professional Modifier Low / Median / High Price $100.76 / $138.55 / $232.02	Professional		$100.76	$138.55	$232.02
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $85.00 / $144.66	Professional	25	$80.00	$85.00	$144.66