Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.56 / $376.00 / $11,627.00	Facility		$67.56	$376.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.00 / $122.21 / $220.03	Professional		$62.00	$122.21	$220.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.15 / $94.15 / $192.33	Professional		$94.15	$94.15	$192.33
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 $61.27 / $102.32 / $194.54	Professional		$61.27	$102.32	$194.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $99.88 / $99.88	Facility		$68.59	$99.88	$99.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.84 / $151.12 / $151.12	Professional		$111.84	$151.12	$151.12
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 $65.91 / $129.63 / $229.39	Professional		$65.91	$129.63	$229.39
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $137.32 / $229.59	Professional		$70.61	$137.32	$229.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.45 / $145.95 / $209.48	Professional		$108.45	$145.95	$209.48
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 $110.90 / $158.43 / $260.52	Professional		$110.90	$158.43	$260.52