Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $75.86 / $93.33	Facility		$52.48	$75.86	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $52.48 / $83.18	Professional		$42.66	$52.48	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $74.13 / $95.50	Professional		$50.12	$74.13	$95.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $104.71 / $213.80	Facility		$100.00	$104.71	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $60.26 / $128.82	Professional		$47.86	$60.26	$128.82
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $89.13 / $89.13	Professional		$83.18	$89.13	$89.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $117.49 / $154.88	Facility		$97.72	$117.49	$154.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $229.09	Professional		$117.49	$131.83	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $72.44	Professional		$52.48	$52.48	$72.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $138.04	Facility		$72.44	$72.44	$138.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $66.07	Professional		$52.48	$52.48	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $109.65	Professional		$53.70	$75.86	$109.65
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $109.65 / $204.17	Professional		$97.72	$109.65	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $53.70 / $112.20	Facility		$40.74	$53.70	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $74.13	Professional		$32.36	$47.86	$74.13