Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $281.84	Facility		$173.78	$173.78	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $177.83 / $281.84	Professional		$144.54	$177.83	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $338.84	Professional		$186.21	$275.42	$338.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $389.05 / $776.25	Facility		$363.08	$389.05	$776.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $467.74	Professional		$173.78	$208.93	$467.74
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $251.19 / $398.11	Facility		$165.96	$251.19	$398.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $446.68	Professional		$218.78	$302.00	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $208.93	Professional		$151.36	$151.36	$208.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $208.93	Professional		$151.36	$151.36	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $398.11	Professional		$199.53	$275.42	$398.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $407.38 / $758.58	Professional		$363.08	$407.38	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $251.19 / $389.05	Facility		$151.36	$251.19	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.83 / $257.04	Professional		$120.23	$177.83	$257.04