Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $45.71 / $162.18	Facility		$19.95	$45.71	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $16.98 / $44.67	Professional		$14.13	$16.98	$44.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $13.18 / $26.30	Professional		$9.55	$13.18	$26.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $19.95 / $34.67	Facility		$17.38	$19.95	$34.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $11.75 / $23.99	Professional		$9.33	$11.75	$23.99
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $12.88 / $26.30	Facility		$12.88	$12.88	$26.30
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $15.14	Professional		$15.14	$15.14	$15.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $19.95 / $23.44	Facility		$12.88	$19.95	$23.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $19.05 / $25.70	Professional		$12.30	$19.05	$25.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $12.30 / $39.81	Facility		$12.30	$12.30	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $12.30 / $35.48	Professional		$9.55	$12.30	$35.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $33.88 / $102.33	Facility		$12.59	$33.88	$102.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $9.55 / $26.30	Professional		$4.17	$9.55	$26.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.49 / $23.44	Professional		$12.88	$15.49	$23.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Facility		$22.91	$22.91	$22.91
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $20.89 / $38.02	Professional		$13.18	$20.89	$38.02
United Facility/Professional Facility Modifier Low / Median / High Price $6.76 / $12.88 / $19.05	Facility		$6.76	$12.88	$19.05
United Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $11.48 / $22.91	Professional		$7.94	$11.48	$22.91