Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.77 / $94.77 / $94.77	Facility		$94.77	$94.77	$94.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.77 / $120.82 / $221.51	Professional		$94.77	$120.82	$221.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.05 / $217.57 / $224.12	Professional		$145.05	$217.57	$224.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.97 / $221.84 / $354.94	Facility		$160.97	$221.84	$354.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.47 / $265.50 / $450.68	Professional		$177.47	$265.50	$450.68
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $290.08 / $317.36 / $376.16	Professional		$290.08	$317.36	$376.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.75 / $148.69 / $376.16	Facility		$17.75	$148.69	$376.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.75 / $150.85 / $394.97	Professional		$17.75	$150.85	$394.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.72 / $126.72 / $378.79	Facility		$126.72	$126.72	$378.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $126.72 / $241.30	Professional		$107.71	$126.72	$241.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $126.72 / $126.72 / $214.48	Facility		$126.72	$126.72	$214.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $126.72 / $126.72 / $166.32	Professional		$126.72	$126.72	$166.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $249.60 / $312.01 / $449.94	Professional		$249.60	$312.01	$449.94
United Facility/Professional Professional Modifier Low / Median / High Price $74.66 / $143.37 / $249.88	Professional		$74.66	$143.37	$249.88