Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $23.99 / $23.99	Facility		$20.89	$23.99	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $23.99 / $45.71	Professional		$18.20	$23.99	$45.71
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $26.30 / $26.30 / $26.30	Professional	25	$26.30	$26.30	$26.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $30.20 / $38.02	Professional		$19.95	$30.20	$38.02
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	25	$30.90	$30.90	$30.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $28.84 / $45.71	Professional		$21.38	$28.84	$45.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $32.36 / $46.77	Facility		$25.70	$32.36	$46.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $36.31 / $47.86	Professional		$28.18	$36.31	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Facility		$46.77	$46.77	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $38.02	Professional		$28.84	$28.84	$38.02
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Professional		$28.84	$28.84	$28.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.11 / $52.48	Professional		$22.39	$33.11	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $27.54 / $48.98	Professional		$19.95	$27.54	$48.98