Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $158.49 / $302.00	Facility		$75.86	$158.49	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $100.00 / $263.03	Professional		$85.11	$100.00	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $93.33	Professional		$72.44	$91.20	$93.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $204.17 / $616.60	Facility		$102.33	$204.17	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $107.15 / $169.82	Professional		$97.72	$107.15	$169.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $38.90	Facility		$38.02	$38.02	$38.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $162.18	Professional		$107.15	$107.15	$162.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $107.15 / $269.15	Facility		$20.89	$107.15	$269.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $162.18	Professional		$107.15	$107.15	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $208.93	Professional		$109.65	$147.91	$208.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $239.88	Professional		$91.20	$117.49	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $117.49	Professional		$91.20	$114.82	$117.49