Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $2,089.30 / $10,715.19	Facility		$177.83	$2,089.30	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $181.97 / $389.05	Professional		$104.71	$181.97	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $186.21	Professional		$169.82	$169.82	$186.21
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 $95.50 / $162.18 / $269.15	Professional		$95.50	$162.18	$269.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
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 $114.82 / $190.55 / $338.84	Professional		$114.82	$190.55	$338.84
Medical Mutual of Ohio 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
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $323.59	Professional		$112.20	$186.21	$323.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $95.50	Professional		$32.36	$33.11	$95.50
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 $109.65 / $194.98 / $302.00	Professional		$109.65	$194.98	$302.00
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 $100.00 / $162.18 / $275.42	Professional		$100.00	$162.18	$275.42