Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $323.59 / $831.76	Facility		$134.90	$323.59	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $125.89 / $524.81	Professional		$112.20	$125.89	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $104.71	Professional		$97.72	$97.72	$104.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $208.93 / $724.44	Facility		$120.23	$208.93	$724.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $125.89 / $213.80	Professional		$112.20	$125.89	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $112.20	Facility		$104.71	$104.71	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $758.58	Professional		$112.20	$112.20	$758.58
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $112.20	Facility		$104.71	$104.71	$112.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $758.58	Professional		$112.20	$112.20	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $162.18	Professional		$112.20	$138.04	$162.18
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $251.19	Professional		$109.65	$181.97	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $114.82	Facility		$112.20	$112.20	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $144.54	Professional		$112.20	$112.20	$144.54