Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $416.87 / $588.84	Facility		$208.93	$416.87	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $208.93 / $371.54	Professional		$158.49	$208.93	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $245.47	Professional		$102.33	$102.33	$245.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $263.03 / $457.09	Facility		$229.09	$263.03	$457.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $218.78 / $371.54	Professional		$31.62	$218.78	$371.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $257.04 / $309.03	Facility		$128.82	$257.04	$309.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $245.47 / $331.13	Professional		$162.18	$245.47	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $162.18 / $851.14	Facility		$120.23	$162.18	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $162.18	Professional		$60.26	$60.26	$162.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $257.04 / $851.14	Facility		$120.23	$257.04	$851.14
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $218.78	Professional		$60.26	$60.26	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $204.17 / $309.03	Professional		$165.96	$204.17	$309.03
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $257.04 / $575.44	Professional		$162.18	$257.04	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $125.89 / $223.87	Facility		$89.13	$125.89	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $245.47	Professional		$91.20	$128.82	$245.47