Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $45.71 / $67.61	Facility		$23.99	$45.71	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $24.55 / $53.70	Professional		$23.99	$24.55	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.02 / $12.02	Professional		$12.02	$12.02	$12.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $45.71 / $125.89	Facility		$26.30	$45.71	$125.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $26.92 / $42.66	Professional		$24.55	$26.92	$42.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Facility		$24.55	$24.55	$24.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Professional		$33.11	$33.11	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $22.91 / $24.55	Facility		$22.91	$22.91	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $31.62	Professional		$24.55	$24.55	$31.62
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $24.55 / $52.48	Facility		$22.91	$24.55	$52.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $24.55 / $31.62	Professional		$21.88	$24.55	$31.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.90 / $35.48	Professional		$24.55	$30.90	$35.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $31.62 / $43.65	Professional		$18.62	$31.62	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Facility		$24.55	$24.55	$24.55
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $26.30	Professional		$24.55	$24.55	$26.30