Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $263.03	Facility		$165.96	$165.96	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $177.83 / $269.15	Professional		$144.54	$177.83	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $371.54 / $741.31	Facility		$346.74	$371.54	$741.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $208.93 / $446.68	Professional		$165.96	$208.93	$446.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $251.19 / $407.38	Facility		$169.82	$251.19	$407.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $457.09	Professional		$218.78	$302.00	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $218.78	Professional		$162.18	$162.18	$218.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $218.78	Professional		$162.18	$162.18	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $302.00	Professional		$147.91	$208.93	$302.00
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $389.05 / $724.44	Professional		$346.74	$389.05	$724.44
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $239.88 / $371.54	Facility		$144.54	$239.88	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $245.47	Professional		$114.82	$169.82	$245.47