Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $69.18 / $89.13	Facility		$50.12	$69.18	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $72.44	Professional		$38.02	$50.12	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $100.00 / $204.17	Facility		$95.50	$100.00	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $54.95 / $120.23	Professional		$45.71	$54.95	$120.23
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $85.11	Professional		$79.43	$79.43	$85.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $85.11 / $134.90	Facility		$56.23	$85.11	$134.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $151.36	Professional		$72.44	$102.33	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $60.26	Professional		$44.67	$44.67	$60.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $154.88	Facility		$60.26	$60.26	$154.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $60.26	Professional		$44.67	$44.67	$60.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $81.28	Professional		$40.74	$57.54	$81.28
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $107.15 / $194.98	Professional		$95.50	$107.15	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $48.98 / $102.33	Facility		$37.15	$48.98	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $67.61	Professional		$30.90	$44.67	$67.61