Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.35 / $84.35 / $217.00	Facility		$84.35	$84.35	$217.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.63 / $84.35 / $97.84	Professional		$70.63	$84.35	$97.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.34 / $88.34 / $124.07	Professional		$88.34	$88.34	$124.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.47 / $172.76 / $447.59	Facility		$147.47	$172.76	$447.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.61 / $85.06 / $206.36	Professional		$76.61	$85.06	$206.36
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $133.49 / $133.49 / $141.35	Professional		$133.49	$133.49	$141.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $130.35 / $172.76 / $233.26	Facility		$130.35	$172.76	$233.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.79 / $180.61 / $266.99	Professional		$117.79	$180.61	$266.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.60 / $102.60 / $182.97	Facility		$102.60	$102.60	$182.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $74.90 / $130.59	Professional		$74.90	$74.90	$130.59
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $102.60 / $102.60 / $102.60	Facility		$102.60	$102.60	$102.60
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $102.60 / $102.60	Professional		$74.90	$102.60	$102.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $84.90 / $116.74 / $153.05	Professional		$84.90	$116.74	$153.05
United Facility/Professional Professional Modifier Low / Median / High Price $52.24 / $77.66 / $106.19	Professional		$52.24	$77.66	$106.19