Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $79.43 / $112.20	Facility		$39.81	$79.43	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $39.81 / $91.20	Professional		$38.90	$39.81	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $46.77 / $46.77	Professional		$39.81	$46.77	$46.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $74.13 / $204.17	Facility		$42.66	$74.13	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $45.71 / $69.18	Professional		$39.81	$45.71	$69.18
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Facility		$19.05	$19.05	$19.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Facility		$46.77	$46.77	$46.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $63.10	Professional		$46.77	$46.77	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $75.86	Facility		$38.02	$38.02	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $64.57	Professional		$39.81	$39.81	$64.57
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $39.81 / $91.20	Facility		$38.02	$39.81	$91.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $87.10	Professional		$39.81	$39.81	$87.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $14.13 / $48.98	Professional		$8.32	$14.13	$48.98
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $46.77	Facility		$39.81	$39.81	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $42.66 / $51.29	Professional		$38.90	$42.66	$51.29