Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.90 / $79.43 / $173.78	Facility		$4.90	$79.43	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $6.17 / $302.00	Professional		$2.00	$6.17	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2.45 / $2.45 / $3.09	Professional		$2.45	$2.45	$3.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3.16 / $6.31 / $19.05	Facility		$3.16	$6.31	$19.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $3.39 / $5.50	Professional		$2.95	$3.39	$5.50
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $6.92 / $6.92 / $6.92	Facility		$6.92	$6.92	$6.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $2.95 / $5.89	Professional		$2.95	$2.95	$5.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.45 / $2.45 / $3.72	Facility		$2.45	$2.45	$3.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2.45 / $2.45 / $5.75	Professional		$2.45	$2.45	$5.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.75 / $2.75 / $85.11	Facility		$2.75	$2.75	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $2.95 / $5.01	Professional		$2.95	$2.95	$5.01
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2.95 / $9.33 / $29.51	Facility		$2.95	$9.33	$29.51
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $2.95 / $7.24	Professional		$2.95	$2.95	$7.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.45 / $3.09 / $4.07	Professional		$2.45	$3.09	$4.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $3.72 / $5.89	Professional		$2.95	$3.72	$5.89
United Facility/Professional Professional Modifier Low / Median / High Price $2.75 / $2.95 / $37.15	Professional		$2.75	$2.95	$37.15