Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.37 / $103.37 / $355.00	Facility		$103.37	$103.37	$355.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.45 / $103.37 / $132.96	Professional		$90.45	$103.37	$132.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.35 / $144.35 / $298.31	Professional		$144.35	$144.35	$298.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.72 / $211.71 / $548.51	Facility		$180.72	$211.71	$548.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.88 / $105.86 / $255.10	Professional		$93.88	$105.86	$255.10
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $163.59 / $163.59 / $163.59	Professional		$163.59	$163.59	$163.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $144.35 / $192.46 / $259.82	Facility		$144.35	$192.46	$259.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.76 / $174.12 / $412.10	Professional		$125.76	$174.12	$412.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.42 / $107.42 / $226.73	Facility		$107.42	$107.42	$226.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.42 / $78.42 / $153.94	Professional		$78.42	$78.42	$153.94
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $107.42 / $107.42 / $153.94	Facility		$107.42	$107.42	$153.94
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $78.42 / $107.42 / $137.22	Professional		$78.42	$107.42	$137.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.07 / $130.72 / $171.37	Professional		$95.07	$130.72	$171.37
United Facility/Professional Facility Modifier Low / Median / High Price $54.62 / $85.00 / $153.97	Facility		$54.62	$85.00	$153.97
United Facility/Professional Professional Modifier Low / Median / High Price $64.01 / $91.36 / $131.22	Professional		$64.01	$91.36	$131.22