Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $426.58 / $812.83	Facility		$199.53	$426.58	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $295.12 / $501.19	Professional		$218.78	$295.12	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $660.69	Professional		$407.38	$407.38	$660.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $588.84 / $1,202.26	Facility		$562.34	$588.84	$1,202.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $323.59 / $707.95	Professional		$269.15	$323.59	$707.95
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $478.63	Professional		$467.74	$467.74	$478.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $416.87 / $660.69	Facility		$275.42	$416.87	$660.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $501.19 / $741.31	Professional		$354.81	$501.19	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $338.84 / $338.84	Facility		$323.59	$338.84	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $338.84	Professional		$245.47	$245.47	$338.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $338.84 / $338.84	Facility		$144.54	$338.84	$338.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $338.84	Professional		$245.47	$245.47	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $331.13 / $467.74	Professional		$234.42	$331.13	$467.74
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $630.96 / $1,148.15	Professional		$562.34	$630.96	$1,148.15
United Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $263.03 / $562.34	Facility		$186.21	$263.03	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $371.54	Professional		$181.97	$263.03	$371.54