Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.48 / $167.27 / $9,516.00	Facility		$55.48	$167.27	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.94 / $64.34 / $156.82	Professional		$29.94	$64.34	$156.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.72 / $65.72 / $85.44	Professional		$65.72	$65.72	$85.44
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 $31.84 / $55.34 / $115.36	Professional		$31.84	$55.34	$115.36
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.76 / $83.02 / $173.04	Professional	50	$47.76	$83.02	$173.04
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $90.19 / $106.10 / $110.34	Professional		$90.19	$106.10	$110.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.25 / $44.06 / $51.94	Facility		$35.25	$44.06	$51.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $98.30 / $126.75 / $154.63	Professional		$98.30	$126.75	$154.63
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 $34.54 / $84.31 / $145.53	Professional		$34.54	$84.31	$145.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $138.25 / $138.25 / $138.25	Facility		$138.25	$138.25	$138.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $37.01 / $85.70 / $145.53	Professional		$37.01	$85.70	$145.53
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 $66.31 / $107.91 / $177.77	Professional		$66.31	$107.91	$177.77