Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $107.15 / $426.58	Facility		$31.62	$107.15	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $51.29 / $93.33	Professional		$19.95	$51.29	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $20.42	Professional		$15.14	$15.14	$20.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $26.92 / $46.77	Facility		$23.44	$26.92	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $15.49 / $32.36	Professional		$12.59	$15.49	$32.36
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $17.38	Facility		$17.38	$17.38	$17.38
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $20.42	Professional		$20.42	$20.42	$20.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $26.92 / $31.62	Facility		$16.98	$26.92	$31.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $25.70 / $34.67	Professional		$16.60	$25.70	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $16.60 / $79.43	Facility		$16.60	$16.60	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $16.60 / $36.31	Professional		$12.88	$16.60	$36.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $63.10 / $131.83	Facility		$16.60	$63.10	$131.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $18.62 / $40.74	Professional		$10.23	$18.62	$40.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $20.89 / $31.62	Professional		$17.38	$20.89	$31.62
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Facility		$30.20	$30.20	$30.20
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $26.92 / $58.88	Professional		$16.60	$26.92	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $17.38 / $25.70	Facility		$9.12	$17.38	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $15.14 / $30.20	Professional		$10.72	$15.14	$30.20