Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $295.12 / $660.69	Facility		$120.23	$295.12	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $128.82 / $371.54	Professional		$104.71	$128.82	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $199.53	Professional		$104.71	$123.03	$199.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $194.98 / $691.83	Facility		$114.82	$194.98	$691.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $199.53	Professional		$104.71	$117.49	$199.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $104.71	Facility		$100.00	$100.00	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $575.44	Professional		$104.71	$104.71	$575.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $302.00 / $512.86	Facility		$100.00	$302.00	$512.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $575.44	Professional		$104.71	$104.71	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $131.83 / $158.49	Professional		$104.71	$131.83	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $177.83 / $245.47	Professional		$104.71	$177.83	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $112.20	Facility		$104.71	$104.71	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $138.04	Professional		$104.71	$104.71	$138.04