Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.63 / $9.12 / $2,089.30	Facility		$3.63	$9.12	$2,089.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3.02 / $3.63 / $112.20	Professional		$3.02	$3.63	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $3.63 / $3.63	Professional		$3.63	$3.63	$3.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3.89 / $6.76 / $18.62	Facility		$3.89	$6.76	$18.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $4.07 / $6.31	Professional		$3.63	$4.07	$6.31
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $9.55 / $9.55	Facility		$9.55	$9.55	$9.55
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $4.07 / $4.07 / $4.07	Professional		$4.07	$4.07	$4.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.37 / $4.37 / $6.61	Facility		$4.37	$4.37	$6.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4.37 / $4.37 / $10.00	Professional		$4.37	$4.37	$10.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.39 / $3.39 / $8.13	Facility		$3.39	$3.39	$8.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $3.63 / $6.17	Professional		$3.63	$3.63	$6.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2.40 / $3.63 / $85.11	Facility		$2.40	$3.63	$85.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $3.63 / $12.59	Professional		$3.63	$3.63	$12.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $4.47 / $5.89	Professional		$3.63	$4.47	$5.89
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $3.80 / $5.01 / $9.33	Professional		$3.80	$5.01	$9.33
United Facility/Professional Facility Modifier Low / Median / High Price $3.63 / $3.63 / $4.37	Facility		$3.63	$3.63	$4.37
United Facility/Professional Professional Modifier Low / Median / High Price $3.39 / $3.72 / $4.27	Professional		$3.39	$3.72	$4.27