Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $102.33 / $199.53	Facility		$44.67	$102.33	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $42.66 / $169.82	Professional		$34.67	$42.66	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $32.36 / $32.36	Professional		$24.55	$32.36	$32.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $50.12 / $87.10	Facility		$42.66	$50.12	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.18 / $60.26	Professional		$23.44	$28.18	$60.26
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Facility		$31.62	$31.62	$31.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $48.98 / $58.88	Facility		$38.02	$48.98	$58.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $63.10	Professional		$30.20	$46.77	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.90 / $158.49	Facility		$30.20	$30.90	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $30.20 / $67.61	Professional		$23.99	$30.20	$67.61
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $69.18 / $169.82	Facility		$32.36	$69.18	$169.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $30.20 / $79.43	Professional		$12.02	$30.20	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $38.90 / $57.54	Professional		$31.62	$38.90	$57.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Facility		$56.23	$56.23	$56.23
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $48.98 / $109.65	Professional		$30.20	$48.98	$109.65
United Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $32.36 / $46.77	Facility		$16.98	$32.36	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $56.23	Professional		$19.95	$28.18	$56.23