Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $271.18 / $1,113.35	Facility		$108.47	$271.18	$1,113.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $148.96	Professional		$108.47	$108.47	$148.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.28 / $109.28 / $109.28	Professional		$109.28	$109.28	$109.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.15 / $186.03 / $309.14	Facility		$117.15	$186.03	$309.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $123.65 / $185.71	Professional		$108.47	$123.65	$185.71
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $145.35 / $145.35 / $145.35	Facility		$145.35	$145.35	$145.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $108.47 / $163.79	Facility		$108.47	$108.47	$163.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $146.43	Professional		$108.47	$108.47	$146.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $108.47 / $163.28	Facility		$102.33	$108.47	$163.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $192.09	Professional		$108.47	$108.47	$192.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $136.05 / $195.07 / $364.30	Facility		$136.05	$195.07	$364.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $192.09	Professional		$108.47	$108.47	$192.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.28 / $137.75 / $188.01	Professional		$109.28	$137.75	$188.01
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $152.40	Professional		$108.47	$108.47	$152.40