Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $245.47 / $478.63	Facility		$95.50	$245.47	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $114.82 / $186.21	Professional		$109.65	$114.82	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $234.42 / $707.95	Facility		$120.23	$234.42	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $123.03 / $194.98	Professional		$109.65	$123.03	$194.98
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $109.65	Facility		$104.71	$104.71	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $199.53	Professional		$109.65	$109.65	$199.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $134.90 / $380.19	Facility		$70.79	$134.90	$380.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $199.53	Professional		$109.65	$109.65	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $173.78	Professional		$109.65	$138.04	$173.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $181.97 / $251.19	Professional		$107.15	$181.97	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $144.54	Professional		$109.65	$109.65	$144.54