Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.53 / $517.94 / $5,513.97	Facility		$86.53	$517.94	$5,513.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $90.82 / $160.41	Professional		$65.48	$90.82	$160.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.16 / $99.88 / $101.87	Professional		$72.16	$99.88	$101.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.40 / $72.77 / $131.37	Professional		$46.40	$72.77	$131.37
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $84.80 / $99.77 / $99.77	Professional		$84.80	$99.77	$99.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.34 / $89.18 / $104.78	Facility		$71.34	$89.18	$104.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.36 / $114.60 / $139.81	Professional		$88.36	$114.60	$139.81
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 $66.70 / $95.08 / $163.31	Professional		$66.70	$95.08	$163.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $166.12 / $358.61 / $5,127.55	Facility		$166.12	$358.61	$5,127.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $62.14 / $97.06 / $164.82	Professional		$62.14	$97.06	$164.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $110.13 / $155.52	Professional		$81.79	$110.13	$155.52
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 $66.08 / $90.95 / $150.28	Professional		$66.08	$90.95	$150.28