Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $70.79 / $141.25	Facility		$41.69	$70.79	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $41.69 / $57.54	Professional		$22.91	$41.69	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $50.12 / $67.61	Professional		$33.88	$50.12	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $114.82	Professional		$30.20	$41.69	$114.82
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $66.07 / $66.07	Professional		$64.57	$66.07	$66.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $50.12 / $79.43	Facility		$33.11	$50.12	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $89.13	Professional		$42.66	$60.26	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $39.81 / $48.98	Facility		$33.88	$39.81	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $39.81	Professional		$33.88	$33.88	$39.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $39.81 / $91.20	Facility		$33.88	$39.81	$91.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $39.81	Professional		$33.88	$33.88	$39.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $95.50 / $467.74	Professional		$52.48	$95.50	$467.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $138.04	Professional		$66.07	$74.13	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $30.20 / $43.65	Facility		$22.39	$30.20	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $30.90 / $43.65	Professional		$19.50	$30.90	$43.65