Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $234.42 / $1,122.02	Facility		$125.89	$234.42	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $446.68	Professional		$104.71	$104.71	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $194.98 / $676.08	Facility		$112.20	$194.98	$676.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $177.83	Professional		$104.71	$117.49	$177.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $147.91	Professional		$109.65	$109.65	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $208.93	Facility		$97.72	$97.72	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $169.82	Professional		$104.71	$104.71	$169.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $162.18 / $457.09	Facility		$97.72	$162.18	$457.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $190.55	Professional		$104.71	$104.71	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $120.23 / $151.36	Professional		$104.71	$120.23	$151.36
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $144.54	Professional		$75.86	$109.65	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $109.65	Facility		$104.71	$104.71	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $154.88	Professional		$104.71	$109.65	$154.88