Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $28.18 / $42.66	Facility		$23.99	$28.18	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $21.88 / $30.90	Professional		$15.85	$21.88	$30.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $69.18	Professional		$33.88	$46.77	$69.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $48.98 / $97.72	Facility		$45.71	$48.98	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.30 / $58.88	Professional		$21.88	$26.30	$58.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $28.18 / $45.71	Facility		$19.05	$28.18	$45.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.88 / $51.29	Professional		$24.55	$33.88	$51.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Facility		$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $30.20	Professional		$21.88	$21.88	$30.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $52.48	Facility		$30.20	$30.20	$52.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $30.20	Professional		$21.88	$21.88	$30.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $27.54 / $39.81	Professional		$19.50	$27.54	$39.81
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $51.29 / $95.50	Professional		$45.71	$51.29	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $19.95 / $41.69	Facility		$15.14	$19.95	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $20.42 / $28.84	Professional		$13.80	$20.42	$28.84