Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $93.33 / $114.82	Facility		$64.57	$93.33	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $97.72	Professional		$52.48	$64.57	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $131.83 / $263.03	Facility		$123.03	$131.83	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $74.13 / $158.49	Professional		$58.88	$74.13	$158.49
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $89.13 / $144.54	Facility		$60.26	$89.13	$144.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $162.18	Professional		$77.62	$107.15	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $75.86	Professional		$54.95	$54.95	$75.86
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $162.18	Facility		$75.86	$75.86	$162.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $75.86	Professional		$54.95	$54.95	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $74.13 / $107.15	Professional		$52.48	$74.13	$107.15
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $138.04 / $257.04	Professional		$123.03	$138.04	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $64.57 / $138.04	Facility		$45.71	$64.57	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $91.20	Professional		$40.74	$60.26	$91.20