Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.62 / $123.54 / $306.77	Facility		$27.62	$123.54	$306.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.18 / $125.84 / $211.87	Professional		$78.18	$125.84	$211.87
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $100.90 / $134.90 / $202.87	Professional	25	$100.90	$134.90	$202.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.29 / $121.26 / $187.95	Professional		$110.29	$121.26	$187.95
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $119.24 / $121.26 / $122.89	Professional	25	$119.24	$121.26	$122.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.28 / $116.64 / $180.74	Professional		$86.28	$116.64	$180.74
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $108.22 / $127.32 / $139.44	Professional		$108.22	$127.32	$139.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $121.26 / $145.51 / $181.89	Facility		$121.26	$145.51	$181.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.26 / $157.63 / $199.71	Professional		$121.26	$157.63	$199.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $146.59 / $146.59	Facility		$146.59	$146.59	$146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $116.36	Professional		$116.36	$116.36	$116.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $146.59 / $146.59	Facility		$146.59	$146.59	$146.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $186.47	Professional		$116.36	$116.36	$186.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.08 / $145.49 / $204.05	Professional		$105.08	$145.49	$204.05
United Facility/Professional Professional Modifier Low / Median / High Price $93.44 / $132.15 / $197.80	Professional		$93.44	$132.15	$197.80