Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.46 / $146.12 / $315.00	Facility		$91.46	$146.12	$315.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.59 / $144.22 / $235.92	Professional		$109.59	$144.22	$235.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.86 / $117.15 / $163.50	Professional		$87.86	$117.15	$163.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $123.00	Facility		$120.00	$120.00	$123.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $153.00 / $238.71	Professional		$98.11	$153.00	$238.71
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $141.69 / $141.69 / $141.69	Facility		$141.69	$141.69	$141.69
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $122.63 / $163.50 / $212.55	Professional		$122.63	$163.50	$212.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.28 / $141.69 / $191.30	Facility		$106.28	$141.69	$191.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $186.48 / $228.90	Professional		$134.88	$186.48	$228.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $246.37 / $246.37 / $246.37	Facility		$246.37	$246.37	$246.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $150.41 / $287.83	Professional		$102.00	$150.41	$287.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $246.37 / $246.37 / $246.37	Facility		$246.37	$246.37	$246.37
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $111.79 / $159.91 / $274.87	Professional		$111.79	$159.91	$274.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $129.70 / $171.77 / $243.98	Professional		$129.70	$171.77	$243.98
Optum Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $166.12 / $295.26	Professional		$110.00	$166.12	$295.26
United Facility/Professional Professional Modifier Low / Median / High Price $111.99 / $174.28 / $302.89	Professional		$111.99	$174.28	$302.89