Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $222.13 / $752.66 / $3,847.00	Facility		$222.13	$752.66	$3,847.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.25 / $226.75 / $429.54	Professional		$138.25	$226.75	$429.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.43 / $322.10 / $332.00	Professional		$183.43	$322.10	$332.00
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 $111.68 / $182.72 / $342.53	Professional		$111.68	$182.72	$342.53
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $260.85 / $267.97 / $267.97	Professional		$260.85	$267.97	$267.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.37 / $176.71 / $209.98	Facility		$141.37	$176.71	$209.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $246.61 / $320.14 / $390.55	Professional		$246.61	$320.14	$390.55
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 $148.44 / $241.72 / $425.47	Professional		$148.44	$241.72	$425.47
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $19.64 / $668.84 / $956.22	Facility		$19.64	$668.84	$956.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $149.85 / $249.00 / $398.19	Professional		$149.85	$249.00	$398.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.13 / $227.79 / $353.05	Professional		$33.13	$227.79	$353.05
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 $188.89 / $258.76 / $425.82	Professional		$188.89	$258.76	$425.82