Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $323.59 / $707.95	Facility		$154.88	$323.59	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $208.93	Professional		$85.11	$112.20	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $165.96 / $288.40	Facility		$144.54	$165.96	$288.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $125.89 / $213.80	Professional		$31.62	$125.89	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $165.96 / $194.98	Facility		$79.43	$165.96	$194.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $213.80	Professional		$102.33	$154.88	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $537.03	Facility		$102.33	$102.33	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $109.65	Professional		$83.18	$83.18	$109.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $263.03 / $537.03	Facility		$102.33	$263.03	$537.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $263.03	Professional		$83.18	$83.18	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $128.82 / $194.98	Professional		$104.71	$128.82	$194.98
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $363.08	Professional		$102.33	$165.96	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $81.28 / $141.25	Facility		$56.23	$81.28	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $74.13 / $154.88	Professional		$51.29	$74.13	$154.88