Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $45.71 / $123.03	Facility		$15.14	$45.71	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.88 / $40.74	Professional		$12.02	$12.88	$40.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $9.33 / $52.48	Professional		$9.33	$9.33	$52.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $28.18 / $85.11	Facility		$14.13	$28.18	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $24.55 / $35.48	Professional		$15.85	$24.55	$35.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $74.13 / $79.43	Facility		$56.23	$74.13	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $134.90	Professional		$56.23	$77.62	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $13.18 / $13.18	Facility		$13.18	$13.18	$13.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $15.49	Professional		$13.18	$13.18	$15.49
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $46.77 / $102.33	Facility		$13.18	$46.77	$102.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $19.95	Professional		$13.18	$13.18	$19.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $128.82 / $186.21	Professional		$32.36	$128.82	$186.21
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $19.05 / $35.48	Professional		$13.80	$19.05	$35.48
United Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $15.49	Professional		$12.88	$12.88	$15.49