Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $177.83 / $389.05	Facility		$72.44	$177.83	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $371.54	Professional		$100.00	$128.82	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $181.97 / $323.59	Professional		$177.83	$181.97	$323.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $257.04 / $524.81	Facility		$245.47	$257.04	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $309.03	Professional		$114.82	$141.25	$309.03
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $218.78 / $218.78	Professional		$204.17	$218.78	$218.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $288.40 / $371.54	Facility		$234.42	$288.40	$371.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $323.59 / $537.03	Professional		$288.40	$323.59	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $154.88	Facility		$151.36	$151.36	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $151.36	Professional		$112.20	$112.20	$151.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $151.36 / $501.19	Facility		$53.70	$151.36	$501.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $154.88	Professional		$112.20	$112.20	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $169.82	Professional		$83.18	$117.49	$169.82
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $275.42 / $489.78	Professional		$239.88	$275.42	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $114.82 / $245.47	Facility		$81.28	$114.82	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $162.18	Professional		$79.43	$112.20	$162.18