Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $83.18 / $281.84	Facility		$45.71	$83.18	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $83.18 / $123.03	Professional		$61.66	$83.18	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $204.17	Professional		$117.49	$128.82	$204.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $169.82 / $346.74	Facility		$162.18	$169.82	$346.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $204.17	Professional		$77.62	$91.20	$204.17
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $144.54	Professional		$134.90	$144.54	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $117.49 / $190.55	Facility		$79.43	$117.49	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $213.80	Professional		$102.33	$141.25	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $89.13	Professional		$64.57	$64.57	$89.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $213.80	Facility		$89.13	$89.13	$213.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $93.33	Professional		$64.57	$64.57	$93.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $138.04	Professional		$69.18	$95.50	$138.04
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $331.13	Professional		$162.18	$177.83	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $75.86 / $162.18	Facility		$53.70	$75.86	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $74.13 / $107.15	Professional		$52.48	$74.13	$107.15