Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $79.43	Professional		$39.81	$57.54	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $102.33 / $141.25	Facility		$95.50	$102.33	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $85.11 / $162.18	Professional		$74.13	$85.11	$162.18
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $107.15 / $109.65	Professional		$102.33	$107.15	$109.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $50.12 / $93.33	Facility		$6.31	$50.12	$93.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $61.66 / $89.13	Professional		$8.13	$61.66	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $81.28	Facility		$60.26	$60.26	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $95.50	Professional		$51.29	$51.29	$95.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $81.28	Facility		$60.26	$60.26	$81.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $51.29 / $79.43	Professional		$5.25	$51.29	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $162.18	Professional		$81.28	$102.33	$162.18
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $177.83	Professional		$89.13	$107.15	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $6.03 / $45.71 / $70.79	Facility		$6.03	$45.71	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $51.29 / $85.11	Professional		$31.62	$51.29	$85.11