Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,995.26 / $7,079.46	Facility		$199.53	$1,995.26	$7,079.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $457.09	Professional		$112.20	$208.93	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $251.19	Professional		$79.43	$141.25	$251.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,238.72 / $3,981.07	Facility		$707.95	$2,238.72	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $281.84	Professional		$120.23	$165.96	$281.84
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $177.83 / $190.55	Facility		$112.20	$177.83	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $426.58	Professional		$194.98	$245.47	$426.58
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 $141.25 / $213.80 / $363.08	Professional		$141.25	$213.80	$363.08
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,318.26 / $3,019.95	Facility		$588.84	$1,318.26	$3,019.95
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $190.55 / $316.23	Professional		$102.33	$190.55	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
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 $134.90 / $208.93 / $371.54	Professional		$134.90	$208.93	$371.54
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 $123.03 / $177.83 / $288.40	Professional		$123.03	$177.83	$288.40