Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.19 / $57.59 / $202.84	Facility		$43.19	$57.59	$202.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $60.91 / $94.97	Professional		$43.19	$60.91	$94.97
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $14.48 / $70.06 / $76.20	Professional	25	$14.48	$70.06	$76.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $69.48 / $69.48	Professional		$69.48	$69.48	$69.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.19 / $54.71 / $90.18	Professional		$45.19	$54.71	$90.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.48 / $86.85 / $103.20	Facility		$69.48	$86.85	$103.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.82 / $90.32 / $166.75	Professional		$48.82	$90.32	$166.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.98 / $79.51 / $124.49	Professional		$61.98	$79.51	$124.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $61.98 / $86.85 / $124.49	Professional		$61.98	$86.85	$124.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.60 / $66.98 / $83.44	Professional		$51.60	$66.98	$83.44
United Facility/Professional Professional Modifier Low / Median / High Price $59.81 / $76.29 / $110.92	Professional		$59.81	$76.29	$110.92