Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $114.82 / $141.25	Facility		$79.43	$114.82	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $128.82	Professional		$58.88	$75.86	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $158.49 / $323.59	Facility		$151.36	$158.49	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $47.86 / $181.97	Professional		$39.81	$47.86	$181.97
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $112.20 / $177.83	Facility		$74.13	$112.20	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $199.53	Professional		$95.50	$134.90	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $83.18	Professional		$61.66	$61.66	$83.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $107.15	Professional		$61.66	$61.66	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $131.83 / $190.55	Professional		$83.18	$131.83	$190.55
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $169.82 / $309.03	Professional		$151.36	$169.82	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $72.44 / $151.36	Facility		$51.29	$72.44	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $70.79 / $107.15	Professional		$48.98	$70.79	$107.15