Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.52 / $197.39 / $454.55	Facility		$157.52	$197.39	$454.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.37 / $165.28 / $295.33	Professional		$136.37	$165.28	$295.33
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $182.00 / $260.77	Professional	25	$115.53	$182.00	$260.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.37 / $165.08 / $213.11	Professional		$151.37	$165.08	$213.11
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $142.53 / $156.18 / $165.55	Professional	25	$142.53	$156.18	$165.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.59 / $147.83 / $229.52	Professional		$109.59	$147.83	$229.52
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $154.28 / $161.99 / $169.71	Professional		$154.28	$161.99	$169.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.28 / $185.14 / $231.42	Facility		$154.28	$185.14	$231.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.28 / $200.56 / $254.09	Professional		$154.28	$200.56	$254.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $175.00	Professional		$147.60	$147.60	$175.00
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 $138.30 / $192.11 / $293.95	Professional		$138.30	$192.11	$293.95