Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $2,041.74 / $10,715.19	Facility		$239.88	$2,041.74	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $239.88 / $575.44	Professional		$144.54	$239.88	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $181.97	Professional		$109.65	$109.65	$181.97
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 $141.25 / $213.80 / $346.74	Professional		$141.25	$213.80	$346.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
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 $162.18 / $257.04 / $467.74	Professional		$162.18	$257.04	$467.74
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 $147.91 / $245.47 / $407.38	Professional		$147.91	$245.47	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $128.82	Professional		$32.36	$33.11	$128.82
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 $144.54 / $245.47 / $436.52	Professional		$144.54	$245.47	$436.52
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 $141.25 / $223.87 / $363.08	Professional		$141.25	$223.87	$363.08