Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $354.81 / $891.25	Facility		$123.03	$354.81	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $489.78	Professional		$162.18	$218.78	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $295.12 / $549.54	Professional		$190.55	$295.12	$549.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $416.87 / $851.14	Facility		$398.11	$416.87	$851.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $501.19	Professional		$131.83	$177.83	$501.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $446.68 / $512.86	Facility		$275.42	$446.68	$512.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $588.84	Professional		$446.68	$501.19	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $234.42	Professional		$169.82	$169.82	$234.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $234.42 / $630.96	Facility		$87.10	$234.42	$630.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $263.03	Professional		$169.82	$169.82	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $436.52	Professional		$218.78	$302.00	$436.52
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $446.68 / $812.83	Professional		$398.11	$446.68	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $199.53 / $426.58	Facility		$141.25	$199.53	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $181.97 / $338.84	Professional		$125.89	$181.97	$338.84