Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $1,513.56 / $8,912.51	Facility		$229.09	$1,513.56	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $512.86	Professional		$134.90	$229.09	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $269.15	Professional		$102.33	$134.90	$269.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $331.13	Professional		$131.83	$199.53	$331.13
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $263.03 / $263.03	Professional		$251.19	$263.03	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $190.55 / $204.17	Facility		$120.23	$190.55	$204.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $302.00 / $524.81	Professional		$239.88	$302.00	$524.81
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 $154.88 / $245.47 / $446.68	Professional		$154.88	$245.47	$446.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $457.09 / $21,379.62	Facility		$316.23	$457.09	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $371.54	Professional		$112.20	$208.93	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $120.23	Professional		$32.36	$33.11	$120.23
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $501.19	Facility		$100.00	$100.00	$501.19
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $239.88 / $371.54	Professional		$138.04	$239.88	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $954.99 / $2,951.21	Facility		$316.23	$954.99	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $213.80 / $346.74	Professional		$134.90	$213.80	$346.74