Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $87.10 / $125.89	Facility		$83.18	$87.10	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $125.89	Professional		$19.05	$19.05	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $5.89 / $10.96 / $11.22	Professional		$5.89	$10.96	$11.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $10.96 / $24.55	Professional		$8.71	$10.96	$24.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $18.62 / $18.62	Facility		$18.62	$18.62	$18.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $0.35 / $1.51 / $4.17	Facility		$0.35	$1.51	$4.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $12.59 / $30.20	Professional		$10.96	$12.59	$30.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $0.35 / $1.51 / $4.17	Facility		$0.35	$1.51	$4.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $10.96 / $12.59	Professional		$10.96	$10.96	$12.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $12.02 / $16.60	Facility		$8.32	$12.02	$16.60
United Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $13.18 / $25.70	Professional		$9.33	$13.18	$25.70