Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.68 / $157.82 / $361.28	Facility		$114.68	$157.82	$361.28
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $140.51 / $428.84 / $674.00	Facility	25	$140.51	$428.84	$674.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.78 / $145.40 / $220.94	Professional		$106.78	$145.40	$220.94
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $127.53 / $142.16 / $261.39	Professional	25	$127.53	$142.16	$261.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.57 / $165.39 / $191.67	Professional		$154.57	$165.39	$191.67
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $153.60 / $153.60 / $156.49	Professional	25	$153.60	$153.60	$156.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.55 / $127.91 / $214.00	Professional		$90.55	$127.91	$214.00
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $131.38 / $162.30 / $177.76	Professional		$131.38	$162.30	$177.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $165.71 / $165.71 / $165.71	Facility		$165.71	$165.71	$165.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $174.07 / $174.07	Facility		$174.07	$174.07	$174.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $174.07 / $174.07	Facility		$174.07	$174.07	$174.07
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.57 / $181.10 / $257.35	Professional		$132.57	$181.10	$257.35
United Facility/Professional Professional Modifier Low / Median / High Price $109.53 / $174.23 / $284.58	Professional		$109.53	$174.23	$284.58