Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.49 / $163.03 / $484.00	Facility		$87.49	$163.03	$484.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.35 / $163.03 / $198.84	Professional		$128.35	$163.03	$198.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.79 / $239.79 / $239.79	Professional		$239.79	$239.79	$239.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $285.01 / $333.88 / $865.06	Facility		$285.01	$333.88	$865.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $148.00 / $394.58	Professional		$125.00	$148.00	$394.58
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $258.00 / $258.00 / $258.00	Professional		$258.00	$258.00	$258.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.88 / $303.52 / $409.77	Facility		$199.88	$303.52	$409.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $197.29 / $273.18 / $649.91	Professional		$197.29	$273.18	$649.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.81 / $175.81 / $191.33	Facility		$175.81	$175.81	$191.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.34 / $128.34 / $191.33	Professional		$128.34	$128.34	$191.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $175.81 / $175.81 / $191.33	Facility		$175.81	$175.81	$191.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $128.34 / $175.81 / $191.33	Professional		$128.34	$175.81	$191.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $164.10 / $225.64 / $295.81	Professional		$164.10	$225.64	$295.81
United Facility/Professional Professional Modifier Low / Median / High Price $100.05 / $142.55 / $200.33	Professional		$100.05	$142.55	$200.33