Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $46.77 / $114.82	Facility		$15.14	$46.77	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $25.12 / $40.74	Professional		$18.20	$25.12	$40.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $53.70	Professional		$30.20	$40.74	$53.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $38.02 / $77.62	Facility		$36.31	$38.02	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $37.15 / $61.66	Professional		$32.36	$37.15	$61.66
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Professional		$45.71	$45.71	$45.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $30.90 / $50.12	Facility		$20.89	$30.90	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $37.15 / $56.23	Professional		$26.92	$37.15	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $42.66	Facility		$38.02	$38.02	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $38.02	Professional		$32.36	$32.36	$38.02
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $38.02 / $56.23	Facility		$13.18	$38.02	$56.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $38.02	Professional		$32.36	$32.36	$38.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $66.07	Professional		$32.36	$45.71	$66.07
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $128.82	Professional		$54.95	$67.61	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $29.51 / $56.23	Facility		$22.91	$29.51	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $30.90 / $44.67	Professional		$19.95	$30.90	$44.67