Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $144.54 / $218.78	Facility		$79.43	$144.54	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $79.43 / $109.65	Professional		$77.62	$79.43	$109.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $134.90 / $281.84	Facility		$85.11	$134.90	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $87.10 / $138.04	Professional		$79.43	$87.10	$138.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $79.43	Facility		$74.13	$74.13	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $123.03	Professional		$79.43	$79.43	$123.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $158.49	Facility		$74.13	$74.13	$158.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $123.03	Professional		$79.43	$79.43	$123.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $114.82	Professional		$79.43	$97.72	$114.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $134.90 / $186.21	Professional		$81.28	$134.90	$186.21
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $95.50	Professional		$79.43	$79.43	$95.50