Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $109.65 / $109.65	Facility		$81.28	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $190.55	Professional		$87.10	$125.89	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $125.89 / $144.54	Professional		$112.20	$125.89	$144.54
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $112.20 / $117.49 / $138.04	Professional	25	$112.20	$117.49	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $302.00	Professional		$131.83	$169.82	$302.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $138.04 / $138.04	Facility		$134.90	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $173.78 / $288.40	Professional		$154.88	$173.78	$288.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $169.82 / $257.04	Professional		$165.96	$169.82	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $239.88	Professional		$120.23	$151.36	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $288.40	Professional		$128.82	$181.97	$288.40