Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $1,096.48 / $9,549.93	Facility		$35.48	$1,096.48	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $61.66 / $165.96	Professional		$19.95	$61.66	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $72.44 / $79.43	Professional		$15.85	$72.44	$79.43
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 $22.91 / $38.02 / $83.18	Professional		$22.91	$38.02	$83.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $57.54 / $125.89	Professional	50	$34.67	$57.54	$125.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $26.30 / $28.84	Facility		$16.98	$26.30	$28.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $169.82	Professional		$79.43	$100.00	$169.82
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 $21.38 / $60.26 / $123.03	Professional		$21.38	$60.26	$123.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $151.36 / $416.87	Facility		$48.98	$151.36	$416.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $60.26 / $117.49	Professional		$20.42	$60.26	$117.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $32.36 / $33.11	Professional		$15.49	$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 $21.38 / $61.66 / $120.23	Professional		$21.38	$61.66	$120.23
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 $20.89 / $47.86 / $104.71	Professional		$20.89	$47.86	$104.71