Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $363.08	Facility		$213.80	$213.80	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $229.09 / $363.08	Professional		$186.21	$229.09	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $346.74 / $446.68	Professional		$239.88	$346.74	$446.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $467.74 / $954.99	Facility		$446.68	$467.74	$954.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $562.34	Professional		$213.80	$269.15	$562.34
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $323.59 / $524.81	Facility		$218.78	$323.59	$524.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $389.05 / $588.84	Professional		$281.84	$389.05	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $281.84	Professional		$204.17	$204.17	$281.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $281.84	Professional		$204.17	$204.17	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $380.19	Professional		$190.55	$263.03	$380.19
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Facility		$537.03	$537.03	$537.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $912.01	Professional		$446.68	$501.19	$912.01
United Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $323.59 / $501.19	Facility		$181.97	$323.59	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $331.13	Professional		$144.54	$218.78	$331.13