Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.52 / $75.52 / $199.00	Facility		$75.52	$75.52	$199.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.59 / $75.52 / $103.99	Professional		$73.59	$75.52	$103.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.99 / $115.99 / $122.18	Professional		$115.99	$115.99	$122.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $145.22 / $170.12 / $440.75	Facility		$145.22	$170.12	$440.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.43 / $84.48 / $203.21	Professional		$75.43	$84.48	$203.21
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $131.44 / $131.44 / $131.44	Professional		$131.44	$131.44	$131.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $115.99 / $154.65 / $208.78	Facility		$115.99	$154.65	$208.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $101.05 / $139.91 / $331.14	Professional		$101.05	$139.91	$331.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.03 / $100.03 / $182.18	Facility		$100.03	$100.03	$182.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $73.02 / $127.79	Professional		$73.02	$73.02	$127.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $100.03 / $100.03 / $100.03	Facility		$100.03	$100.03	$100.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $100.03 / $100.03	Professional		$73.02	$100.03	$100.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.60 / $114.96 / $150.71	Professional		$83.60	$114.96	$150.71
United Facility/Professional Professional Modifier Low / Median / High Price $51.44 / $77.15 / $106.19	Professional		$51.44	$77.15	$106.19