Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $263.03 / $1,230.27	Facility		$70.79	$263.03	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $457.09	Professional		$63.10	$85.11	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $81.28 / $107.15	Professional		$70.79	$81.28	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $154.88	Professional		$70.79	$95.50	$154.88
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $72.44 / $100.00	Facility		$54.95	$72.44	$100.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $112.20	Professional		$66.07	$89.13	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $134.90 / $147.91	Facility		$125.89	$134.90	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $151.36	Professional		$64.57	$91.20	$151.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $144.54	Professional		$64.57	$91.20	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $69.18	Professional		$32.36	$33.11	$69.18
Optum Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $162.18	Professional		$83.18	$100.00	$162.18
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $93.33 / $138.04	Professional		$72.44	$93.33	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $173.78	Professional		$70.79	$95.50	$173.78