Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.56 / $103.43 / $385.17	Facility		$77.56	$103.43	$385.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.56 / $115.92 / $206.73	Professional		$77.56	$115.92	$206.73
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.72 / $128.72 / $128.72	Professional	25	$128.72	$128.72	$128.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.82 / $124.82 / $124.82	Professional		$124.82	$124.82	$124.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $84.42 / $154.90	Professional		$70.20	$84.42	$154.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $124.82 / $156.03 / $185.39	Facility		$124.82	$156.03	$185.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $162.27 / $299.57	Professional		$91.00	$162.27	$299.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.43 / $147.29 / $223.84	Professional		$116.43	$147.29	$223.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $116.43 / $156.02 / $223.84	Professional		$116.43	$156.02	$223.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.59 / $137.41 / $170.78	Professional		$106.59	$137.41	$170.78
United Facility/Professional Professional Modifier Low / Median / High Price $111.97 / $136.19 / $208.34	Professional		$111.97	$136.19	$208.34