Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $58.88 / $109.65	Facility		$28.18	$58.88	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.30 / $58.88	Professional		$21.88	$26.30	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $20.42	Professional		$20.42	$20.42	$20.42
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 $14.45 / $18.20 / $37.15	Professional		$14.45	$18.20	$37.15
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 $19.95 / $19.95 / $33.88	Facility		$19.95	$19.95	$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 / $19.50 / $109.65	Facility		$19.05	$19.50	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.05 / $54.95	Professional		$15.14	$19.05	$54.95
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $33.11 / $112.20	Facility		$19.05	$33.11	$112.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $22.91 / $44.67	Professional		$15.49	$22.91	$44.67
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 / $35.48	Facility		$35.48	$35.48	$35.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.90 / $69.18	Professional		$19.05	$30.90	$69.18
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