Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $223.87 / $407.38	Facility		$56.23	$223.87	$407.38
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $23.99 / $208.93 / $489.78	Facility	25	$23.99	$208.93	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $478.63	Professional		$147.91	$239.88	$478.63
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $316.23 / $524.81	Professional	25	$128.82	$316.23	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $380.19	Professional		$181.97	$263.03	$380.19
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $213.80 / $263.03 / $338.84	Professional	25	$213.80	$263.03	$338.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $371.54	Professional		$169.82	$229.09	$371.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $173.78 / $229.09	Facility		$134.90	$173.78	$229.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $549.54	Professional		$208.93	$263.03	$549.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $234.42 / $331.13	Facility		$208.93	$234.42	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $398.11	Professional		$151.36	$257.04	$398.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $407.38	Facility		$181.97	$181.97	$407.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $257.04 / $426.58	Professional		$158.49	$257.04	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $302.00 / $426.58	Professional		$173.78	$302.00	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $316.23	Facility		$269.15	$269.15	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $380.19	Professional		$147.91	$239.88	$380.19