Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $15.85 / $15.85	Facility		$15.85	$15.85	$15.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.95 / $28.18	Professional		$15.85	$19.95	$28.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $40.74	Professional		$26.30	$26.30	$40.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $35.48 / $63.10	Professional		$23.99	$35.48	$63.10
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $44.67 / $50.12	Professional		$41.69	$44.67	$50.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.24 / $16.98 / $38.02	Facility		$2.24	$16.98	$38.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2.69 / $20.42 / $34.67	Professional		$2.69	$20.42	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $30.20	Facility		$19.95	$19.95	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $33.88	Professional		$16.98	$16.98	$33.88
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $35.48	Facility		$19.95	$19.95	$35.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $16.98 / $35.48	Professional		$2.00	$16.98	$35.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $43.65 / $70.79	Professional		$35.48	$43.65	$70.79
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $50.12 / $70.79	Professional		$36.31	$50.12	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $2.04 / $17.38 / $27.54	Facility		$2.04	$17.38	$27.54
United Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $21.38 / $35.48	Professional		$11.48	$21.38	$35.48