Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.41 / $770.11 / $3,893.00	Facility		$129.41	$770.11	$3,893.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.56 / $90.15 / $213.56	Professional		$46.56	$90.15	$213.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.49 / $53.34 / $58.19	Professional		$48.49	$53.34	$58.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $2,012.00 / $3,943.00	Facility		$937.00	$2,012.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.14 / $54.32 / $132.44	Professional		$36.14	$54.32	$132.44
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $54.21 / $81.48 / $198.66	Professional	50	$54.21	$81.48	$198.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.05 / $71.31 / $84.10	Facility		$57.05	$71.31	$84.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.94 / $158.57 / $193.45	Professional		$121.94	$158.57	$193.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.91 / $103.33 / $192.95	Professional		$55.91	$103.33	$192.95
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $409.90 / $782.16 / $1,954.06	Facility		$409.90	$782.16	$1,954.06
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $57.49 / $106.98 / $191.26	Professional		$57.49	$106.98	$191.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.45 / $145.95 / $209.48	Professional		$108.45	$145.95	$209.48
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $975.00 / $2,914.00	Facility		$444.00	$975.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.92 / $128.84 / $232.09	Professional		$79.92	$128.84	$232.09