Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $114.82	Facility		$60.26	$60.26	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $95.50	Professional		$46.77	$60.26	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $131.83 / $269.15	Facility		$125.89	$131.83	$269.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $158.49	Professional		$60.26	$70.79	$158.49
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $83.18 / $131.83	Facility		$54.95	$83.18	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $147.91	Professional		$70.79	$100.00	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $69.18	Professional		$50.12	$50.12	$69.18
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $69.18	Professional		$50.12	$50.12	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $107.15	Professional		$53.70	$75.86	$107.15
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $141.25 / $263.03	Professional		$125.89	$141.25	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $83.18 / $128.82	Facility		$50.12	$83.18	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $61.66 / $85.11	Professional		$40.74	$61.66	$85.11