Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $979.48 / $3,291.00	Facility		$200.00	$979.48	$3,291.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.93 / $184.21 / $341.50	Professional		$105.93	$184.21	$341.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.44 / $149.44 / $149.44	Professional		$149.44	$149.44	$149.44
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 $104.07 / $142.44 / $264.80	Professional		$104.07	$142.44	$264.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.53 / $119.41 / $141.88	Facility		$95.53	$119.41	$141.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.16 / $197.79 / $241.29	Professional		$155.16	$197.79	$241.29
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 $100.51 / $170.95 / $315.74	Professional		$100.51	$170.95	$315.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $338.85 / $645.45 / $1,370.85	Facility		$338.85	$645.45	$1,370.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $100.51 / $178.09 / $315.64	Professional		$100.51	$178.09	$315.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.09 / $146.81 / $220.97	Professional		$96.09	$146.81	$220.97
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 $128.47 / $182.84 / $300.61	Professional		$128.47	$182.84	$300.61