Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $96.26 / $3,696.00	Facility		$37.92	$96.26	$3,696.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.61 / $39.00 / $73.23	Professional		$21.61	$39.00	$73.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.32 / $42.32 / $42.32	Professional		$42.32	$42.32	$42.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.32 / $31.14 / $60.33	Professional		$22.32	$31.14	$60.33
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $33.47 / $46.72 / $90.49	Professional	50	$33.47	$46.72	$90.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.63 / $28.29 / $33.27	Facility		$22.63	$28.29	$33.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.11 / $56.01 / $68.33	Professional		$43.11	$56.01	$68.33
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 $22.18 / $41.49 / $72.61	Professional		$22.18	$41.49	$72.61
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $51.27 / $119.68 / $147.88	Facility		$51.27	$119.68	$147.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $23.77 / $45.64 / $73.29	Professional		$23.77	$45.64	$73.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.68 / $74.53 / $102.79	Professional		$54.68	$74.53	$102.79
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $975.00 / $2,914.00	Facility		$444.00	$975.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $35.68 / $46.56 / $79.34	Professional		$35.68	$46.56	$79.34