Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $257.04	Facility		$134.90	$134.90	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $234.42	Professional		$120.23	$158.49	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $302.00 / $616.60	Facility		$288.40	$302.00	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $363.08	Professional		$141.25	$173.78	$363.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $208.93 / $338.84	Facility		$141.25	$208.93	$338.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $380.19	Professional		$181.97	$251.19	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $173.78	Professional		$128.82	$128.82	$173.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $173.78	Professional		$128.82	$128.82	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $309.03	Professional		$154.88	$218.78	$309.03
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $316.23 / $588.84	Professional		$288.40	$316.23	$588.84
United Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $208.93 / $323.59	Facility		$125.89	$208.93	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $138.04 / $213.80	Professional		$93.33	$138.04	$213.80