Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $41.69 / $707.95	Facility		$16.98	$41.69	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $16.98 / $35.48	Professional		$12.88	$16.98	$35.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $27.54 / $45.71	Professional		$23.99	$27.54	$45.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $34.67 / $69.18	Facility		$32.36	$34.67	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $18.62 / $41.69	Professional		$15.49	$18.62	$41.69
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $27.54	Professional		$26.92	$26.92	$27.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $25.70 / $40.74	Facility		$16.98	$25.70	$40.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.20 / $45.71	Professional		$21.88	$30.20	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $31.62	Facility		$22.39	$22.39	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $22.39	Professional		$16.22	$16.22	$22.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $22.39 / $31.62	Facility		$13.18	$22.39	$31.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $22.39	Professional		$16.22	$16.22	$22.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $19.50 / $27.54	Professional		$13.80	$19.50	$27.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $37.15 / $67.61	Professional		$32.36	$37.15	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $16.60 / $34.67	Facility		$12.30	$16.60	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $15.14 / $22.91	Professional		$10.72	$15.14	$22.91