Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.23 / $248.00 / $10,268.00	Facility		$67.23	$248.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.14 / $99.32 / $206.81	Professional		$54.14	$99.32	$206.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.27 / $123.61 / $173.05	Professional		$81.27	$123.61	$173.05
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 $51.69 / $83.02 / $162.41	Professional		$51.69	$83.02	$162.41
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $118.73 / $118.73 / $139.68	Professional		$118.73	$118.73	$139.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.08 / $73.84 / $87.05	Facility		$59.08	$73.84	$87.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.44 / $166.87 / $203.58	Professional		$128.44	$166.87	$203.58
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 $57.90 / $112.79 / $203.04	Professional		$57.90	$112.79	$203.04
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $135.75 / $135.75 / $135.75	Facility		$135.75	$135.75	$135.75
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $62.03 / $121.14 / $203.04	Professional		$62.03	$121.14	$203.04
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 $82.42 / $135.79 / $268.70	Professional		$82.42	$135.79	$268.70