Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $758.58 / $10,471.29	Facility		$30.90	$758.58	$10,471.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $23.99 / $9,332.54	Professional		$22.91	$23.99	$9,332.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $23.99	Professional		$23.99	$23.99	$23.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $44.67 / $154.88	Facility		$25.70	$44.67	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $26.92 / $41.69	Professional		$23.99	$26.92	$41.69
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Facility		$31.62	$31.62	$31.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $41.69	Facility		$27.54	$27.54	$41.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $64.57	Professional		$27.54	$27.54	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $18.20 / $44.67	Facility		$18.20	$18.20	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $33.11	Professional		$23.99	$23.99	$33.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $70.79 / $134.90	Facility		$18.20	$70.79	$134.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $50.12	Professional		$23.99	$23.99	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $29.51 / $38.90	Professional		$23.99	$29.51	$38.90
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $29.51 / $54.95	Professional		$25.12	$29.51	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $27.54	Facility		$23.99	$23.99	$27.54
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $25.12 / $31.62	Professional		$23.44	$25.12	$31.62