Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $74.13 / $229.09	Facility		$35.48	$74.13	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $70.79	Professional		$28.84	$33.88	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $26.92 / $30.90	Professional		$19.05	$26.92	$30.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $40.74 / $70.79	Facility		$35.48	$40.74	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.44 / $50.12	Professional		$19.05	$23.44	$50.12
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $40.74 / $47.86	Facility		$26.30	$40.74	$47.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.90 / $52.48	Professional		$25.12	$38.90	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $125.89	Facility		$25.12	$25.12	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.12 / $54.95	Professional		$19.50	$25.12	$54.95
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $48.98 / $158.49	Facility		$12.59	$48.98	$158.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $21.88 / $69.18	Professional		$8.51	$21.88	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $47.86	Professional		$25.70	$31.62	$47.86
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Facility		$45.71	$45.71	$45.71
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $40.74 / $75.86	Professional		$25.12	$40.74	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $26.30 / $38.90	Facility		$13.80	$26.30	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $22.91 / $50.12	Professional		$16.22	$22.91	$50.12