Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $275.42 / $338.84	Facility		$190.55	$275.42	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $275.42	Professional		$141.25	$186.21	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $186.21	Professional		$162.18	$162.18	$186.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $380.19 / $776.25	Facility		$363.08	$380.19	$776.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $457.09	Professional		$173.78	$208.93	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $269.15 / $426.58	Facility		$177.83	$269.15	$426.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $323.59 / $478.63	Professional		$229.09	$323.59	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $199.53	Professional		$144.54	$144.54	$199.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $489.78	Facility		$199.53	$199.53	$489.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $199.53	Professional		$144.54	$144.54	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $446.68	Professional		$194.98	$302.00	$446.68
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $407.38 / $741.31	Professional		$363.08	$407.38	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $169.82 / $363.08	Facility		$123.03	$169.82	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $239.88	Professional		$117.49	$169.82	$239.88