Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $467.74 / $8,912.51	Facility		$54.95	$467.74	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $69.18 / $269.15	Professional		$23.99	$69.18	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $56.23 / $79.43	Professional		$33.11	$56.23	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $50.12 / $89.13	Professional		$26.30	$50.12	$89.13
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $63.10 / $63.10	Professional		$61.66	$63.10	$63.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $29.51 / $33.11	Facility		$19.05	$29.51	$33.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $125.89	Professional		$57.54	$72.44	$125.89
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 $25.12 / $52.48 / $107.15	Professional		$25.12	$52.48	$107.15
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $128.82 / $21,379.62	Facility		$46.77	$128.82	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $53.70 / $100.00	Professional		$23.44	$53.70	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $32.36 / $33.11	Professional		$12.02	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $52.48 / $91.20	Professional		$21.88	$52.48	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $47.86 / $85.11	Professional		$23.44	$47.86	$85.11