Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $218.78 / $467.74	Facility		$85.11	$218.78	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $199.53	Professional		$63.10	$77.62	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $51.29 / $128.82	Professional		$44.67	$51.29	$128.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $89.13 / $154.88	Facility		$77.62	$89.13	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $114.82	Professional		$41.69	$51.29	$114.82
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $97.72 / $120.23	Facility		$67.61	$97.72	$120.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $102.33 / $114.82	Professional		$85.11	$102.33	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $57.54 / $323.59	Facility		$54.95	$57.54	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $75.86 / $165.96	Professional		$43.65	$75.86	$165.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $147.91 / $380.19	Facility		$54.95	$147.91	$380.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $169.82	Professional		$42.66	$67.61	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $104.71	Professional		$64.57	$75.86	$104.71
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $199.53	Professional		$72.44	$104.71	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $75.86 / $85.11	Facility		$30.90	$75.86	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $51.29 / $117.49	Professional		$35.48	$51.29	$117.49