Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $2,691.53 / $10,715.19	Facility		$288.40	$2,691.53	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $660.69	Professional		$173.78	$295.12	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $295.12 / $346.74	Professional		$158.49	$295.12	$346.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $2,041.74 / $3,981.07	Facility		$776.25	$2,041.74	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $467.74	Professional		$199.53	$281.84	$467.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $338.84 / $588.84	Professional		$208.93	$338.84	$588.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $562.34	Professional		$199.53	$338.84	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $141.25	Professional		$32.36	$33.11	$141.25
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $912.01	Facility		$100.00	$100.00	$912.01
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $331.13 / $524.81	Professional		$173.78	$331.13	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $954.99 / $2,951.21	Facility		$467.74	$954.99	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $288.40 / $478.63	Professional		$177.83	$288.40	$478.63