Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $323.59 / $8,912.51	Facility		$25.70	$323.59	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $58.88 / $177.83	Professional		$14.13	$58.88	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $64.57 / $87.10	Professional		$11.75	$64.57	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $35.48 / $77.62	Professional		$19.50	$35.48	$77.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $52.48 / $117.49	Professional	50	$28.84	$52.48	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $18.62 / $20.42	Facility		$11.75	$18.62	$20.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $85.11 / $144.54	Professional		$69.18	$85.11	$144.54
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 $15.49 / $50.12 / $104.71	Professional		$15.49	$50.12	$104.71
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $158.49 / $457.09	Facility		$83.18	$158.49	$457.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $50.12 / $100.00	Professional		$13.80	$50.12	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $32.36 / $33.11	Professional		$9.12	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $245.47	Facility		$100.00	$100.00	$245.47
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $43.65 / $102.33	Professional		$14.79	$43.65	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $35.48 / $87.10	Professional		$14.45	$35.48	$87.10