Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $199.53 / $346.74	Facility		$100.00	$199.53	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $158.49 / $346.74	Professional		$93.33	$158.49	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $104.71 / $190.55	Professional		$102.33	$104.71	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $194.98	Professional		$102.33	$131.83	$194.98
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $120.23 / $173.78	Facility		$91.20	$120.23	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $239.88	Professional		$100.00	$134.90	$239.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $218.78	Professional		$100.00	$138.04	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $239.88	Professional		$107.15	$134.90	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $190.55	Professional		$75.86	$109.65	$190.55