Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $72.44 / $89.13	Facility		$26.92	$72.44	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.99 / $63.10	Professional		$19.05	$23.99	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $18.62 / $18.62	Professional		$14.13	$18.62	$18.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $28.18 / $48.98	Facility		$24.55	$28.18	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $16.22 / $34.67	Professional		$13.18	$16.22	$34.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $28.18 / $33.11	Facility		$21.38	$28.18	$33.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $26.92 / $36.31	Professional		$17.38	$26.92	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $89.13	Facility		$17.38	$17.38	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $17.38 / $38.90	Professional		$13.49	$17.38	$38.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $33.88 / $102.33	Facility		$17.38	$33.88	$102.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.95 / $38.90	Professional		$16.60	$19.95	$38.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $21.88 / $33.11	Professional		$18.20	$21.88	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Facility		$32.36	$32.36	$32.36
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $28.18 / $58.88	Professional		$17.38	$28.18	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $18.20 / $26.92	Facility		$9.55	$18.20	$26.92
United Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $16.22 / $32.36	Professional		$11.22	$16.22	$32.36