Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $242.43 / $1,687.20	Facility		$106.33	$242.43	$1,687.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $164.61	Professional		$106.33	$106.33	$164.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.04 / $136.04 / $136.04	Professional		$136.04	$136.04	$136.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.84 / $182.36 / $303.04	Facility		$114.84	$182.36	$303.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $123.34 / $185.75	Professional		$106.33	$123.34	$185.75
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $142.47 / $142.47 / $142.47	Facility		$142.47	$142.47	$142.47
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $106.33	Professional		$106.33	$106.33	$106.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $136.04 / $190.46	Facility		$106.33	$136.04	$190.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $122.28 / $176.09	Professional		$106.33	$122.28	$176.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.32 / $106.33 / $195.19	Facility		$100.32	$106.33	$195.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $224.33	Professional		$106.33	$106.33	$224.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $135.55 / $210.10 / $1,164.83	Facility		$135.55	$210.10	$1,164.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $259.62	Professional		$106.33	$106.33	$259.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.96 / $163.24 / $207.77	Professional		$116.96	$163.24	$207.77
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $149.38	Professional		$106.33	$106.33	$149.38