Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $57.54 / $173.78	Facility		$33.11	$57.54	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $120.23	Professional		$33.88	$53.70	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $69.18 / $131.83	Professional		$56.23	$69.18	$131.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $74.13 / $151.36	Facility		$70.79	$74.13	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $60.26 / $102.33	Professional		$48.98	$60.26	$102.33
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $75.86	Professional		$74.13	$74.13	$75.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $91.20 / $120.23	Facility		$69.18	$91.20	$120.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $102.33 / $173.78	Professional		$83.18	$102.33	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $75.86	Facility		$67.61	$67.61	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $67.61	Professional		$48.98	$48.98	$67.61
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $67.61 / $141.25	Facility		$19.95	$67.61	$141.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $48.98 / $83.18	Professional		$40.74	$48.98	$83.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $87.10	Professional		$43.65	$61.66	$87.10
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $100.00 / $208.93	Professional		$69.18	$100.00	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $54.95 / $128.82	Facility		$40.74	$54.95	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $74.13	Professional		$33.11	$48.98	$74.13