Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $2,511.89 / $10,715.19	Facility		$165.96	$2,511.89	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $416.87	Professional		$109.65	$169.82	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,137.96 / $2,511.89	Facility		$1,905.46	$2,137.96	$2,511.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $257.04	Professional		$120.23	$158.49	$257.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
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 $128.82 / $186.21 / $309.03	Professional		$128.82	$186.21	$309.03
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 $120.23 / $186.21 / $275.42	Professional		$120.23	$186.21	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $177.83 / $316.23	Professional		$104.71	$177.83	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $263.03	Professional		$109.65	$158.49	$263.03