Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $70.79 / $257.04	Facility		$30.90	$70.79	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.92 / $107.15	Professional		$20.89	$26.92	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $17.78 / $39.81	Professional		$13.18	$17.78	$39.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $30.90 / $54.95	Facility		$26.92	$30.90	$54.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.95 / $38.02	Professional		$16.60	$19.95	$38.02
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $29.51	Facility		$19.95	$19.95	$29.51
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $23.44 / $23.44	Professional		$20.89	$23.44	$23.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $30.90 / $37.15	Facility		$29.51	$30.90	$37.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $29.51 / $39.81	Professional		$19.05	$29.51	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.50 / $61.66	Facility		$19.05	$19.50	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.05 / $56.23	Professional		$15.14	$19.05	$56.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $51.29 / $154.88	Facility		$10.23	$51.29	$154.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $18.20 / $50.12	Professional		$5.50	$18.20	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $24.55 / $36.31	Professional		$19.95	$24.55	$36.31
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $48.98	Facility		$35.48	$35.48	$48.98
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $33.11 / $64.57	Professional		$20.89	$33.11	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $20.42 / $29.51	Facility		$10.72	$20.42	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $17.78 / $35.48	Professional		$12.30	$17.78	$35.48