Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $95.50 / $323.59	Facility		$48.98	$95.50	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $239.88	Professional		$81.28	$100.00	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $85.11 / $107.15	Professional		$25.12	$85.11	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $169.82	Professional		$75.86	$107.15	$169.82
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $173.78	Professional		$72.44	$128.82	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $87.10 / $117.49	Facility		$66.07	$87.10	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $134.90	Professional		$79.43	$104.71	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $147.91 / $158.49	Facility		$141.25	$147.91	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $199.53	Professional		$72.44	$107.15	$199.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $102.33 / $181.97	Professional		$67.61	$102.33	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Optum Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $154.88	Professional		$70.79	$95.50	$154.88
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $165.96	Professional		$91.20	$114.82	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $177.83	Professional		$74.13	$97.72	$177.83