Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.27 / $133.27 / $239.49	Facility		$133.27	$133.27	$239.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.39 / $133.27 / $193.23	Professional		$120.39	$133.27	$193.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.71 / $204.71 / $204.71	Professional		$204.71	$204.71	$204.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $256.29 / $300.23 / $777.88	Facility		$256.29	$300.23	$777.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.15 / $149.12 / $354.82	Professional		$133.15	$149.12	$354.82
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $232.00 / $232.00 / $232.00	Professional		$232.00	$232.00	$232.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $204.71 / $272.94 / $375.36	Facility		$204.71	$272.94	$375.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $177.87 / $255.25 / $584.41	Professional		$177.87	$255.25	$584.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $170.64 / $170.64	Facility		$108.00	$170.64	$170.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.57 / $124.57 / $217.99	Professional		$124.57	$124.57	$217.99
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $170.64 / $170.64	Facility		$108.00	$170.64	$170.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $124.57 / $170.64 / $170.64	Professional		$124.57	$170.64	$170.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.78 / $159.20 / $208.71	Professional		$115.78	$159.20	$208.71
United Facility/Professional Professional Modifier Low / Median / High Price $90.78 / $136.16 / $214.14	Professional		$90.78	$136.16	$214.14