Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $53.70 / $91.20	Facility		$27.54	$53.70	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $28.84 / $69.18	Professional		$25.12	$28.84	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $21.88	Professional		$20.42	$20.42	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $36.31 / $63.10	Facility		$31.62	$36.31	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $19.50 / $43.65	Professional		$15.49	$19.50	$43.65
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $23.44 / $23.44	Facility		$23.44	$23.44	$23.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $36.31 / $42.66	Facility		$22.91	$36.31	$42.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.88 / $45.71	Professional		$22.39	$33.88	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $117.49	Facility		$22.39	$22.39	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $20.42 / $48.98	Professional		$15.85	$20.42	$48.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $35.48 / $117.49	Facility		$22.39	$35.48	$117.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $19.95 / $48.98	Professional		$12.02	$19.95	$48.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.18 / $42.66	Professional		$22.91	$28.18	$42.66
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $40.74	Facility		$40.74	$40.74	$40.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $38.02 / $67.61	Professional		$23.99	$38.02	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $22.39 / $33.88	Facility		$12.30	$22.39	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $20.42 / $40.74	Professional		$14.45	$20.42	$40.74