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 $44.67 / $56.23 / $74.13	Professional		$44.67	$56.23	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $151.36	Professional		$66.07	$74.13	$151.36
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $109.65	Professional		$102.33	$102.33	$109.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5.13 / $46.77 / $87.10	Facility		$5.13	$46.77	$87.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $56.23 / $85.11	Professional		$6.61	$56.23	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $63.10	Facility		$43.65	$43.65	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $87.10	Professional		$37.15	$37.15	$87.10
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $87.10	Facility		$43.65	$43.65	$87.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $74.13	Professional		$37.15	$43.65	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $125.89	Professional		$63.10	$77.62	$125.89
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $177.83	Professional		$89.13	$104.71	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $4.79 / $35.48 / $61.66	Facility		$4.79	$35.48	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $67.61	Professional		$30.90	$46.77	$67.61