Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $524.81	Facility		$154.88	$154.88	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $1,778.28	Professional		$77.62	$107.15	$1,778.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $114.82	Professional		$74.13	$81.28	$114.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $131.83	Professional		$66.07	$81.28	$131.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $151.36	Professional		$81.28	$81.28	$151.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $104.71 / $144.54	Facility		$83.18	$104.71	$144.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $194.98	Professional		$81.28	$104.71	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $138.04 / $138.04	Facility		$72.44	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $186.21	Professional		$72.44	$109.65	$186.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $173.78	Professional		$75.86	$104.71	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $173.78	Professional		$79.43	$93.33	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,202.26 / $1,445.44	Facility		$1,148.15	$1,202.26	$1,445.44
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $154.88	Professional		$63.10	$87.10	$154.88