Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.22 / $70.89 / $163.00	Facility		$26.22	$70.89	$163.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.91 / $36.00 / $63.00	Professional		$23.91	$36.00	$63.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $39.76 / $50.21 / $59.33	Professional	25	$39.76	$50.21	$59.33
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.76 / $15.61 / $21.94	Professional	52	$11.76	$15.61	$21.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.61 / $37.47 / $55.82	Professional		$30.61	$37.47	$55.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $15.93 / $33.60 / $36.54	Professional	25	$15.93	$33.60	$36.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $861.00 / $861.00 / $4,510.00	Facility		$861.00	$861.00	$4,510.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $39.61 / $61.37	Professional		$32.65	$39.61	$61.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.40 / $30.48 / $38.10	Facility		$25.40	$30.48	$38.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $46.81 / $59.30	Professional		$36.01	$46.81	$59.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.77 / $35.77 / $35.77	Facility		$35.77	$35.77	$35.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $34.82 / $34.82	Professional		$34.82	$34.82	$34.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $35.77 / $35.77 / $35.77	Facility		$35.77	$35.77	$35.77
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $34.82 / $34.82	Professional		$34.82	$34.82	$34.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.07 / $35.43 / $50.72	Professional		$26.07	$35.43	$50.72
United Facility/Professional Professional Modifier Low / Median / High Price $28.55 / $42.10 / $76.37	Professional		$28.55	$42.10	$76.37