Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $17.78 / $117.49	Facility		$8.51	$17.78	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $12.88 / $30.20	Professional		$8.51	$12.88	$30.20
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $10.47 / $10.96 / $47.86	Professional	CQ	$10.47	$10.96	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $15.49 / $15.49	Professional		$15.49	$15.49	$15.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $13.18 / $23.44	Professional		$9.77	$13.18	$23.44
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $9.55 / $11.22	Professional		$9.55	$9.55	$11.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $15.85 / $19.05	Facility		$13.49	$15.85	$19.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $15.49 / $32.36	Professional		$13.80	$15.49	$32.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $23.99 / $141.25	Facility		$23.44	$23.99	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $18.62 / $30.20	Professional		$11.48	$18.62	$30.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $75.86 / $131.83	Facility		$35.48	$75.86	$131.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $17.78 / $33.11	Professional		$8.91	$17.78	$33.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $32.36 / $33.11	Professional		$11.48	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $16.98 / $16.98	Facility		$16.98	$16.98	$16.98
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $17.38 / $28.18	Professional		$14.79	$17.38	$28.18
United Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $11.75 / $14.79	Facility		$11.75	$11.75	$14.79
United Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $13.18 / $19.05	Professional		$10.96	$13.18	$19.05