Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.10 / $1,109.00 / $9,504.00	Facility		$142.10	$1,109.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.99 / $132.00 / $265.20	Professional		$63.99	$132.00	$265.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.47 / $152.47 / $152.47	Professional		$152.47	$152.47	$152.47
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 $49.33 / $93.92 / $197.52	Professional		$49.33	$93.92	$197.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.75 / $129.22 / $129.22	Facility		$88.75	$129.22	$129.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.41 / $164.43 / $164.43	Professional		$121.41	$164.43	$164.43
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 $87.01 / $149.47 / $261.58	Professional		$87.01	$149.47	$261.58
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $127.12 / $127.12 / $127.12	Facility		$127.12	$127.12	$127.12
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $90.30 / $152.79 / $250.69	Professional		$90.30	$152.79	$250.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.45 / $163.15 / $242.48	Professional		$117.45	$163.15	$242.48
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 $114.17 / $171.90 / $284.69	Professional		$114.17	$171.90	$284.69