Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $87.10 / $134.90	Facility		$36.31	$87.10	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $36.31 / $66.07	Professional		$30.20	$36.31	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $19.50 / $21.88	Professional		$18.20	$19.50	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $45.71 / $81.28	Facility		$39.81	$45.71	$81.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $23.99 / $57.54	Professional		$19.95	$23.99	$57.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $28.18 / $151.36	Facility		$28.18	$28.18	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $38.02 / $77.62	Professional		$20.42	$38.02	$77.62
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $44.67 / $151.36	Facility		$38.90	$44.67	$151.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $38.90 / $95.50	Professional		$20.42	$38.90	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.90 / $53.70	Professional		$33.11	$38.90	$53.70
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $53.70 / $102.33	Professional		$37.15	$53.70	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $38.90 / $43.65	Facility		$15.85	$38.90	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $26.30 / $56.23	Professional		$18.20	$26.30	$56.23