Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $1,479.11 / $9,120.11	Facility		$120.23	$1,479.11	$9,120.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $128.82 / $363.08	Professional		$70.79	$128.82	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $107.15 / $120.23	Professional		$83.18	$107.15	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $107.15 / $186.21	Professional		$64.57	$107.15	$186.21
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $131.83	Professional		$112.20	$112.20	$131.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $100.00 / $107.15	Facility		$63.10	$100.00	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $158.49	Professional		$128.82	$158.49	$158.49
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 $79.43 / $128.82 / $229.09	Professional		$79.43	$128.82	$229.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $562.34 / $21,379.62	Facility		$501.19	$562.34	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $204.17	Professional		$79.43	$123.03	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $870.96	Facility		$100.00	$100.00	$870.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $125.89 / $190.55	Professional		$77.62	$125.89	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,073.80	Facility		$954.99	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $109.65 / $177.83	Professional		$67.61	$109.65	$177.83