Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.06 / $141.41 / $493.59	Facility		$106.06	$141.41	$493.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.06 / $148.22 / $240.39	Professional		$106.06	$148.22	$240.39
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $231.00 / $235.64 / $235.64	Professional	25	$231.00	$235.64	$235.64
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $170.66 / $170.66 / $170.66	Professional	25	$170.66	$170.66	$170.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.67 / $103.82 / $211.78	Professional		$86.67	$103.82	$211.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $170.66 / $213.33 / $253.47	Facility		$170.66	$213.33	$253.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $116.76 / $221.86 / $409.58	Professional		$116.76	$221.86	$409.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.41 / $183.85 / $305.87	Professional		$150.41	$183.85	$305.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $150.41 / $191.10 / $305.87	Professional		$150.41	$191.10	$305.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $158.20 / $203.66 / $254.23	Professional		$158.20	$203.66	$254.23
United Facility/Professional Professional Modifier Low / Median / High Price $133.71 / $175.32 / $269.16	Professional		$133.71	$175.32	$269.16