Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $128.82 / $218.78	Facility		$97.72	$128.82	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $426.58	Professional		$109.65	$162.18	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $239.88	Professional		$120.23	$158.49	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $223.87	Professional		$93.33	$123.03	$223.87
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $208.93	Professional		$128.82	$169.82	$208.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $151.36 / $208.93	Facility		$123.03	$151.36	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $169.82 / $316.23	Professional		$147.91	$169.82	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $186.21 / $323.59	Professional		$138.04	$186.21	$323.59
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $524.81	Facility		$177.83	$177.83	$524.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $316.23	Professional		$131.83	$186.21	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $107.15 / $162.18	Professional		$33.11	$107.15	$162.18
Optum Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $181.97 / $295.12	Professional		$104.71	$181.97	$295.12
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $302.00	Professional		$138.04	$181.97	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $275.42	Professional		$128.82	$177.83	$275.42