Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $2,344.23 / $8,912.51	Facility		$173.78	$2,344.23	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $181.97 / $436.52	Professional		$102.33	$181.97	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $138.04 / $194.98	Professional		$97.72	$138.04	$194.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $7,943.28	Facility		$1,000.00	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $239.88	Professional		$104.71	$141.25	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $181.97 / $309.03	Professional		$123.03	$181.97	$309.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,398.83 / $9,120.11	Facility		$1,318.26	$2,398.83	$9,120.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $281.84	Professional		$114.82	$173.78	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $2,041.74	Facility		$100.00	$100.00	$2,041.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $302.00	Professional		$117.49	$177.83	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $5,248.07	Facility		$1,698.24	$2,570.40	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $245.47	Professional		$100.00	$147.91	$245.47