Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $138.04 / $245.47	Facility		$77.62	$138.04	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $151.36	Professional		$64.57	$79.43	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $77.62	Professional		$41.69	$41.69	$77.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $102.33 / $181.97	Facility		$89.13	$102.33	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $50.12 / $123.03	Professional		$36.31	$50.12	$123.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $112.20	Facility		$63.10	$63.10	$112.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $131.83	Professional		$63.10	$97.72	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $331.13	Facility		$63.10	$63.10	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $128.82	Professional		$40.74	$53.70	$128.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $100.00 / $208.93	Facility		$63.10	$100.00	$208.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $44.67 / $89.13	Professional		$40.74	$44.67	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $120.23	Professional		$66.07	$81.28	$120.23
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $102.33 / $229.09	Professional		$63.10	$102.33	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $48.98 / $97.72	Facility		$35.48	$48.98	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $54.95 / $117.49	Professional		$38.02	$54.95	$117.49