Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $109.65 / $128.82	Facility		$28.84	$109.65	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $61.66 / $95.50	Professional		$25.12	$61.66	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $112.20	Professional		$100.00	$100.00	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $56.23 / $107.15	Professional		$26.30	$56.23	$107.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $30.20 / $40.74	Facility		$23.99	$30.20	$40.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $147.91	Professional		$74.13	$87.10	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $42.66 / $61.66	Facility		$22.91	$42.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $69.18 / $134.90	Professional		$26.92	$69.18	$134.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $69.18	Facility		$42.66	$42.66	$69.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $69.18 / $128.82	Professional		$26.92	$69.18	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $60.26	Professional		$20.89	$32.36	$60.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $69.18 / $162.18	Professional		$25.12	$69.18	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $169.82	Facility		$162.18	$162.18	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $57.54 / $112.20	Professional		$24.55	$57.54	$112.20