Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $209.77 / $1,872.00 / $5,634.55	Facility		$209.77	$1,872.00	$5,634.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.77 / $172.66 / $313.27	Professional		$126.77	$172.66	$313.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.63 / $161.26 / $177.21	Professional		$80.63	$161.26	$177.21
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 $106.70 / $165.00 / $282.88	Professional		$106.70	$165.00	$282.88
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $194.93 / $200.25 / $200.25	Professional		$194.93	$200.25	$200.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.47 / $170.05 / $204.55	Facility		$140.47	$170.05	$204.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.28 / $194.93 / $402.04	Professional		$141.28	$194.93	$402.04
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 $130.74 / $203.79 / $328.02	Professional		$130.74	$203.79	$328.02
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $113.52 / $934.80 / $1,372.51	Facility		$113.52	$934.80	$1,372.51
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $207.23 / $319.94	Professional		$134.97	$207.23	$319.94
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 $141.41 / $195.97 / $339.84	Professional		$141.41	$195.97	$339.84