Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $72.44 / $9,332.54	Facility		$30.90	$72.44	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.70 / $72.44	Professional		$25.12	$25.70	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Professional		$25.70	$25.70	$25.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $47.86 / $165.96	Facility		$27.54	$47.86	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $29.51 / $44.67	Professional		$25.70	$29.51	$44.67
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $52.48	Professional		$25.70	$25.70	$52.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $38.90	Facility		$25.70	$25.70	$38.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $60.26	Professional		$25.70	$25.70	$60.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $20.42 / $35.48	Facility		$20.42	$20.42	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $35.48	Professional		$25.70	$25.70	$35.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $63.10 / $109.65	Facility		$20.42	$63.10	$109.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $45.71	Professional		$25.70	$25.70	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $28.18 / $37.15	Professional		$25.70	$28.18	$37.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $31.62 / $60.26	Professional		$26.92	$31.62	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Facility		$25.70	$25.70	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $26.30 / $30.20	Professional		$24.55	$26.30	$30.20