Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $1,949.84 / $10,715.19	Facility		$46.77	$1,949.84	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $70.79 / $173.78	Professional		$25.12	$70.79	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $83.18 / $107.15	Professional		$60.26	$83.18	$107.15
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 $34.67 / $57.54 / $107.15	Professional		$34.67	$57.54	$107.15
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $87.10 / $162.18	Professional	50	$51.29	$87.10	$162.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $27.54	Facility		$27.54	$27.54	$27.54
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 $27.54 / $69.18 / $138.04	Professional		$27.54	$69.18	$138.04
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $389.05 / $21,379.62	Facility		$154.88	$389.05	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $69.18 / $131.83	Professional		$26.30	$69.18	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $32.36 / $33.11	Professional		$19.95	$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 $26.30 / $83.18 / $131.83	Professional		$26.30	$83.18	$131.83
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 $26.92 / $58.88 / $114.82	Professional		$26.92	$58.88	$114.82