Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $102.33	Facility		$67.61	$67.61	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $67.61 / $107.15	Professional		$53.70	$67.61	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $100.00 / $138.04	Professional		$75.86	$100.00	$138.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $147.91 / $302.00	Facility		$141.25	$147.91	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $83.18 / $177.83	Professional		$67.61	$83.18	$177.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $102.33 / $162.18	Facility		$67.61	$102.33	$162.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $181.97	Professional		$87.10	$123.03	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $89.13	Professional		$64.57	$64.57	$89.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $81.28	Professional		$64.57	$64.57	$81.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $83.18 / $120.23	Professional		$60.26	$83.18	$120.23
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $288.40	Professional		$141.25	$158.49	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $91.20 / $141.25	Facility		$54.95	$91.20	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $93.33	Professional		$45.71	$67.61	$93.33