Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $141.25	Professional		$75.86	$112.20	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $199.53	Professional		$109.65	$109.65	$199.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $186.21 / $263.03	Facility		$177.83	$186.21	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $288.40	Professional		$97.72	$131.83	$288.40
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $213.80	Professional		$199.53	$199.53	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $100.00 / $177.83	Facility		$10.72	$100.00	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $109.65 / $177.83	Professional		$13.80	$109.65	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $144.54	Facility		$114.82	$114.82	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $177.83	Professional		$97.72	$97.72	$177.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $177.83	Facility		$114.82	$114.82	$177.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $97.72 / $144.54	Professional		$87.10	$97.72	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $154.88 / $245.47	Professional		$123.03	$154.88	$245.47
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $204.17 / $338.84	Professional		$173.78	$204.17	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $70.79 / $117.49	Facility		$8.91	$70.79	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $89.13 / $138.04	Professional		$60.26	$89.13	$138.04