Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $54.95 / $131.83	Facility		$41.69	$54.95	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $70.79	Professional		$37.15	$48.98	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $41.69 / $54.95	Professional		$25.12	$41.69	$54.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $93.33 / $257.04	Facility		$53.70	$93.33	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $48.98 / $81.28	Professional		$44.67	$48.98	$81.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Professional		$66.07	$66.07	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $52.48	Professional		$48.98	$48.98	$52.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $48.98 / $102.33	Facility		$43.65	$48.98	$102.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $52.48	Professional		$48.98	$48.98	$52.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $61.66 / $72.44	Professional		$48.98	$61.66	$72.44
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $81.28 / $114.82	Professional		$52.48	$81.28	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $46.77	Facility		$44.67	$44.67	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $51.29 / $52.48	Professional		$43.65	$51.29	$52.48