Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $57.54 / $83.18	Professional		$38.02	$57.54	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $100.00 / $138.04	Facility		$93.33	$100.00	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $77.62 / $154.88	Professional		$69.18	$77.62	$154.88
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $109.65 / $109.65	Professional		$102.33	$109.65	$109.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5.50 / $48.98 / $81.28	Facility		$5.50	$48.98	$81.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $56.23 / $89.13	Professional		$7.08	$56.23	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $75.86	Facility		$57.54	$57.54	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $93.33	Professional		$48.98	$48.98	$93.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $93.33	Facility		$57.54	$57.54	$93.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $75.86	Professional		$47.86	$57.54	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $158.49	Professional		$79.43	$100.00	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $177.83	Professional		$89.13	$109.65	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $5.25 / $39.81 / $64.57	Facility		$5.25	$39.81	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $50.12 / $77.62	Professional		$30.90	$50.12	$77.62