Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.67 / $23.92 / $91.75	Facility		$8.67	$23.92	$91.75
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $264.39 / $264.39 / $337.35	Facility	25	$264.39	$264.39	$337.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $15.17 / $27.55	Professional		$7.76	$15.17	$27.55
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $16.53 / $16.53 / $16.53	Professional	25	$16.53	$16.53	$16.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.95 / $5.59 / $9.74	Professional	52	$3.95	$5.59	$9.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.48 / $16.18 / $21.44	Professional		$15.48	$16.18	$21.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.17 / $16.18 / $26.74	Professional		$9.17	$16.18	$26.74
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $16.18 / $17.80	Professional		$8.51	$16.18	$17.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $10.21 / $12.72	Facility		$8.51	$10.21	$12.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.18 / $21.03 / $26.65	Professional		$16.18	$21.03	$26.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.08 / $12.08 / $12.08	Facility		$12.08	$12.08	$12.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.77 / $15.77 / $15.77	Professional		$15.77	$15.77	$15.77
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $12.08 / $12.08 / $12.08	Facility		$12.08	$12.08	$12.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $15.77 / $15.77 / $15.77	Professional		$15.77	$15.77	$15.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $14.62 / $20.25 / $35.54	Professional		$14.62	$20.25	$35.54