Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.58 / $772.14 / $4,275.00	Facility		$214.58	$772.14	$4,275.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.46 / $232.81 / $403.88	Professional		$136.46	$232.81	$403.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $238.73 / $238.73 / $324.30	Professional		$238.73	$238.73	$324.30
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 $122.81 / $192.05 / $348.54	Professional		$122.81	$192.05	$348.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $269.76 / $269.76 / $269.76	Professional		$269.76	$269.76	$269.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $139.50 / $203.14 / $203.14	Facility		$139.50	$203.14	$203.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $194.51 / $262.60 / $262.60	Professional		$194.51	$262.60	$262.60
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 $144.93 / $242.72 / $424.21	Professional		$144.93	$242.72	$424.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $191.95 / $338.76 / $766.03	Facility		$191.95	$338.76	$766.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $145.63 / $250.66 / $403.17	Professional		$145.63	$250.66	$403.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $200.66 / $317.56	Professional		$31.68	$200.66	$317.56
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $965.00 / $2,914.00	Facility		$444.00	$965.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.39 / $259.48 / $448.21	Professional		$191.39	$259.48	$448.21