Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $66.07 / $109.65	Facility		$30.90	$66.07	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $27.54 / $64.57	Professional		$22.91	$27.54	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $19.50 / $19.50	Professional		$19.50	$19.50	$19.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $33.88 / $58.88	Facility		$29.51	$33.88	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.50 / $40.74	Professional		$15.85	$19.50	$40.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $37.15	Facility		$21.88	$21.88	$37.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $107.15	Facility		$20.89	$20.89	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $20.89 / $53.70	Professional		$16.22	$20.89	$53.70
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $43.65 / $107.15	Facility		$17.78	$43.65	$107.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $23.99 / $53.70	Professional		$12.88	$23.99	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.92 / $39.81	Professional		$21.88	$26.92	$39.81
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $33.88 / $74.13	Professional		$20.89	$33.88	$74.13
United Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $22.39 / $32.36	Facility		$11.75	$22.39	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $19.50 / $38.90	Professional		$13.49	$19.50	$38.90