Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $239.88 / $354.81	Facility		$134.90	$239.88	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $288.40	Professional		$85.11	$117.49	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $74.13 / $120.23	Professional		$70.79	$74.13	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $151.36 / $263.03	Facility		$131.83	$151.36	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $81.28 / $151.36	Professional		$70.79	$81.28	$151.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $162.18 / $199.53	Facility		$114.82	$162.18	$199.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $190.55	Professional		$141.25	$169.82	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $489.78	Facility		$93.33	$93.33	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $128.82 / $257.04	Professional		$64.57	$128.82	$257.04
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $245.47 / $489.78	Facility		$125.89	$245.47	$489.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $302.00	Professional		$57.54	$97.72	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $177.83	Professional		$107.15	$128.82	$177.83
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $331.13	Professional		$120.23	$173.78	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $128.82 / $141.25	Facility		$51.29	$128.82	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $177.83	Professional		$60.26	$85.11	$177.83