Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $162.18 / $501.19	Facility		$44.67	$162.18	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $147.91 / $245.47	Professional		$56.23	$147.91	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $204.17 / $316.23	Professional		$114.82	$204.17	$316.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $295.12 / $602.56	Facility		$281.84	$295.12	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $363.08	Professional		$128.82	$162.18	$363.08
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $239.88	Professional		$234.42	$234.42	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $331.13 / $426.58	Facility		$269.15	$331.13	$426.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $371.54 / $616.60	Professional		$331.13	$371.54	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $144.54	Facility		$141.25	$141.25	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $141.25	Professional		$104.71	$104.71	$141.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $141.25 / $144.54	Facility		$87.10	$141.25	$144.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $302.00	Professional		$104.71	$104.71	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $257.04	Professional		$125.89	$177.83	$257.04
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $346.74 / $562.34	Professional		$281.84	$346.74	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $134.90 / $281.84	Facility		$95.50	$134.90	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $194.98	Professional		$91.20	$128.82	$194.98