Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $109.65 / $302.00	Facility		$42.66	$109.65	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $32.36 / $93.33	Professional		$29.51	$32.36	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $23.44 / $31.62	Professional		$17.38	$23.44	$31.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $41.69 / $72.44	Facility		$36.31	$41.69	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $20.42 / $30.20	Professional		$16.22	$20.42	$30.20
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $26.92	Facility		$26.92	$26.92	$26.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $31.62 / $31.62	Professional		$27.54	$31.62	$31.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $41.69 / $48.98	Facility		$26.30	$41.69	$48.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $52.48	Professional		$25.70	$38.90	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $83.18	Facility		$25.70	$25.70	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $27.54 / $56.23	Professional		$18.20	$27.54	$56.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $117.49 / $229.09	Facility		$44.67	$117.49	$229.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $5.75 / $20.42 / $58.88	Professional		$5.75	$20.42	$58.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $32.36 / $48.98	Professional		$26.30	$32.36	$48.98
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Facility		$46.77	$46.77	$46.77
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $43.65 / $77.62	Professional		$27.54	$43.65	$77.62
United Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $25.70 / $38.90	Facility		$14.13	$25.70	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $23.44 / $46.77	Professional		$16.60	$23.44	$46.77