Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $87.10 / $363.08	Facility		$23.99	$87.10	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $28.84 / $102.33	Professional		$20.89	$28.84	$102.33
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $30.20 / $72.44 / $97.72	Professional	CQ	$30.20	$72.44	$97.72
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $27.54 / $27.54 / $27.54	Professional	CQ	$27.54	$27.54	$27.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $27.54 / $48.98	Professional		$20.42	$27.54	$48.98
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Professional		$24.55	$24.55	$24.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $39.81 / $47.86	Facility		$33.88	$39.81	$47.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $39.81 / $81.28	Professional		$34.67	$39.81	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $61.66 / $141.25	Facility		$58.88	$61.66	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $43.65 / $70.79	Professional		$27.54	$43.65	$70.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $93.33 / $147.91	Facility		$53.70	$93.33	$147.91
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $44.67 / $70.79	Professional		$24.55	$44.67	$70.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $70.79	Professional		$37.15	$43.65	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $37.15	Facility		$29.51	$29.51	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.88 / $42.66	Professional		$25.70	$33.88	$42.66