Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $141.25 / $281.84	Facility		$117.49	$141.25	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $234.42	Professional		$112.20	$147.91	$234.42
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $234.42 / $234.42 / $234.42	Professional	25	$234.42	$234.42	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $194.98	Professional		$138.04	$165.96	$194.98
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $138.04 / $158.49 / $181.97	Professional	25	$138.04	$158.49	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $128.82 / $257.04	Professional		$102.33	$128.82	$257.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $309.03	Professional		$151.36	$190.55	$309.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $151.36 / $275.42	Professional		$123.03	$151.36	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $229.09 / $371.54	Professional		$177.83	$229.09	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $181.97 / $269.15	Professional		$134.90	$181.97	$269.15