Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $57.54 / $109.65	Facility		$26.30	$57.54	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $26.30 / $77.62	Professional		$22.91	$26.30	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Professional		$14.79	$14.79	$14.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $30.90 / $53.70	Facility		$26.92	$30.90	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $17.78 / $37.15	Professional		$14.45	$17.78	$37.15
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $23.44	Professional		$23.44	$23.44	$23.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $19.50 / $33.88	Facility		$19.50	$19.50	$33.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $95.50	Facility		$19.05	$19.05	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.05 / $42.66	Professional		$14.79	$19.05	$42.66
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $42.66 / $120.23	Facility		$19.05	$42.66	$120.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.91 / $48.98	Professional		$18.20	$22.91	$48.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $23.99 / $36.31	Professional		$19.95	$23.99	$36.31
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Facility		$35.48	$35.48	$35.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.90 / $58.88	Professional		$19.05	$30.90	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $19.95 / $29.51	Facility		$10.47	$19.95	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $17.38 / $35.48	Professional		$12.30	$17.38	$35.48