Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $112.20 / $138.04	Facility		$77.62	$112.20	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $112.20	Professional		$57.54	$75.86	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $158.49 / $316.23	Facility		$147.91	$158.49	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $190.55	Professional		$70.79	$85.11	$190.55
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $109.65 / $177.83	Facility		$74.13	$109.65	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $131.83 / $199.53	Professional		$95.50	$131.83	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $81.28	Professional		$60.26	$60.26	$81.28
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $199.53	Facility		$81.28	$81.28	$199.53
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $81.28	Professional		$60.26	$60.26	$81.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $154.88	Professional		$77.62	$107.15	$154.88
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $165.96 / $309.03	Professional		$147.91	$165.96	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $72.44 / $151.36	Facility		$54.95	$72.44	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $100.00	Professional		$48.98	$69.18	$100.00