Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.69 / $924.02 / $4,642.34	Facility		$161.69	$924.02	$4,642.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.40 / $135.50 / $254.72	Professional		$86.40	$135.50	$254.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.47 / $141.93 / $198.70	Professional		$138.47	$141.93	$198.70
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 $82.87 / $125.20 / $220.60	Professional		$82.87	$125.20	$220.60
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $160.38 / $160.38 / $160.38	Professional		$160.38	$160.38	$160.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.91 / $123.64 / $146.47	Facility		$98.91	$123.64	$146.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.25 / $191.61 / $233.75	Professional		$147.25	$191.61	$233.75
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 $92.97 / $151.68 / $257.99	Professional		$92.97	$151.68	$257.99
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $157.52 / $529.64 / $883.79	Facility		$157.52	$529.64	$883.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.04 / $149.03 / $238.53	Professional		$87.04	$149.03	$238.53
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 $117.74 / $156.99 / $258.64	Professional		$117.74	$156.99	$258.64