Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $282.95 / $898.06 / $3,243.00	Facility		$282.95	$898.06	$3,243.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.35 / $287.66 / $523.70	Professional		$163.35	$287.66	$523.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.19 / $273.35 / $386.76	Professional		$231.19	$273.35	$386.76
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 $138.01 / $218.96 / $403.55	Professional		$138.01	$218.96	$403.55
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $303.89 / $312.17 / $324.66	Professional		$303.89	$312.17	$324.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $177.84 / $222.30 / $263.99	Facility		$177.84	$222.30	$263.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $287.02 / $372.95 / $454.98	Professional		$287.02	$372.95	$454.98
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 $186.73 / $290.07 / $500.80	Professional		$186.73	$290.07	$500.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $257.39 / $718.53 / $1,293.63	Facility		$257.39	$718.53	$1,293.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $186.73 / $303.89 / $463.23	Professional		$186.73	$303.89	$463.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.13 / $261.32 / $401.48	Professional		$33.13	$261.32	$401.48
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 $217.01 / $310.01 / $510.45	Professional		$217.01	$310.01	$510.45