Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $199.53 / $295.12	Facility		$93.33	$199.53	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $331.13	Professional		$104.71	$144.54	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $114.82 / $125.89	Professional		$54.95	$114.82	$125.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $281.84 / $851.14	Facility		$141.25	$281.84	$851.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $134.90 / $223.87	Professional		$123.03	$134.90	$223.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $58.88	Facility		$56.23	$56.23	$58.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $199.53	Professional		$144.54	$144.54	$199.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $302.00	Facility		$144.54	$144.54	$302.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $199.53	Professional		$104.71	$144.54	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $177.83	Professional		$120.23	$151.36	$177.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $154.88 / $323.59	Professional		$144.54	$154.88	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $158.49	Professional		$123.03	$147.91	$158.49