Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $134.90	Professional		$54.95	$87.10	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $123.03	Professional		$87.10	$120.23	$123.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $154.88 / $213.80	Facility		$144.54	$154.88	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $239.88	Professional		$109.65	$117.49	$239.88
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $169.82 / $169.82	Professional		$158.49	$169.82	$169.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $83.18 / $151.36	Facility		$8.32	$83.18	$151.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $89.13 / $151.36	Professional		$10.96	$89.13	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Facility		$91.20	$91.20	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $141.25	Professional		$77.62	$77.62	$141.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Facility		$91.20	$91.20	$117.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $117.49	Professional		$66.07	$77.62	$117.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $144.54 / $229.09	Professional		$93.33	$144.54	$229.09
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $275.42	Professional		$138.04	$162.18	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $63.10 / $100.00	Facility		$8.13	$63.10	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $77.62 / $117.49	Professional		$47.86	$77.62	$117.49