Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.88 / $1,870.31 / $4,668.04	Facility		$213.88	$1,870.31	$4,668.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.18 / $171.68 / $321.75	Professional		$112.18	$171.68	$321.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.96 / $91.70 / $127.62	Professional		$82.96	$91.70	$127.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,051.00 / $1,981.00 / $3,943.00	Facility		$1,051.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.62 / $163.44 / $283.73	Professional		$101.62	$163.44	$283.73
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $200.55 / $200.55 / $206.02	Professional		$200.55	$200.55	$206.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.07 / $176.34 / $209.53	Facility		$141.07	$176.34	$209.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $187.67 / $246.13 / $300.27	Professional		$187.67	$246.13	$300.27
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 $132.61 / $204.20 / $335.65	Professional		$132.61	$204.20	$335.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $585.36 / $970.58 / $1,643.47	Facility		$585.36	$970.58	$1,643.47
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $121.75 / $207.58 / $319.07	Professional		$121.75	$207.58	$319.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $124.79 / $184.91 / $269.15	Professional		$124.79	$184.91	$269.15
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 $155.06 / $201.38 / $365.13	Professional		$155.06	$201.38	$365.13