Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $426.58	Professional		$213.80	$309.03	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $467.74	Professional		$338.84	$338.84	$467.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $501.19 / $707.95	Facility		$467.74	$501.19	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $467.74 / $794.33	Professional		$363.08	$467.74	$794.33
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $630.96 / $660.69	Professional		$575.44	$630.96	$660.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $275.42 / $489.78	Facility		$33.11	$275.42	$489.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $316.23 / $489.78	Professional		$41.69	$316.23	$489.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $426.58	Facility		$302.00	$302.00	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $512.86	Professional		$257.04	$257.04	$512.86
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $512.86	Facility		$302.00	$302.00	$512.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $389.05	Professional		$245.47	$302.00	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $549.54 / $870.96	Professional		$436.52	$549.54	$870.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $588.84 / $1,000.00	Professional		$501.19	$588.84	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $239.88 / $371.54	Facility		$31.62	$239.88	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $288.40 / $467.74	Professional		$165.96	$288.40	$467.74