Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $75.86	Facility		$43.65	$43.65	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $44.67 / $74.13	Professional		$38.02	$44.67	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $69.18 / $74.13	Professional		$46.77	$69.18	$74.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $97.72 / $199.53	Facility		$93.33	$97.72	$199.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $117.49	Professional		$44.67	$54.95	$117.49
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $69.18 / $109.65	Facility		$45.71	$69.18	$109.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $81.28 / $123.03	Professional		$58.88	$81.28	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $50.12	Professional		$37.15	$37.15	$50.12
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $50.12	Professional		$37.15	$37.15	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $79.43	Professional		$39.81	$54.95	$79.43
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $104.71 / $190.55	Professional		$93.33	$104.71	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $60.26 / $93.33	Facility		$33.88	$60.26	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $44.67 / $61.66	Professional		$30.20	$44.67	$61.66