Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.67 / $1,532.00 / $4,404.84	Facility		$169.67	$1,532.00	$4,404.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.28 / $146.21 / $283.82	Professional		$94.28	$146.21	$283.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.41 / $109.86 / $156.94	Professional		$70.41	$109.86	$156.94
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 $81.05 / $135.07 / $238.60	Professional		$81.05	$135.07	$238.60
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $177.34 / $177.34 / $184.43	Professional		$177.34	$177.34	$184.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.32 / $135.40 / $160.62	Facility		$108.32	$135.40	$160.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.75 / $211.87 / $258.47	Professional		$162.75	$211.87	$258.47
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 $101.82 / $167.46 / $283.39	Professional		$101.82	$167.46	$283.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $620.92 / $1,331.71 / $3,413.17	Facility		$620.92	$1,331.71	$3,413.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $160.86 / $262.11	Professional		$84.00	$160.86	$262.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.45 / $163.15 / $242.48	Professional		$117.45	$163.15	$242.48
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,930.00 / $4,067.00	Facility		$1,020.00	$1,930.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $112.11 / $169.77 / $283.56	Professional		$112.11	$169.77	$283.56