Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $2,290.87 / $8,912.51	Facility		$138.04	$2,290.87	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $138.04 / $354.81	Professional		$81.28	$138.04	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $69.18 / $158.49	Professional		$36.31	$69.18	$158.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $7,943.28	Facility		$1,000.00	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $245.47	Professional		$100.00	$154.88	$245.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $234.42 / $363.08	Professional	50	$147.91	$234.42	$363.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $112.20 / $123.03	Facility		$70.79	$112.20	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $199.53 / $346.74	Professional		$154.88	$199.53	$346.74
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 $89.13 / $154.88 / $263.03	Professional		$89.13	$154.88	$263.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,778.28 / $3,235.94	Facility		$1,148.15	$1,778.28	$3,235.94
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $257.04	Professional		$87.10	$151.36	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
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 $87.10 / $158.49 / $257.04	Professional		$87.10	$158.49	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $5,248.07	Facility		$1,698.24	$2,570.40	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $234.42	Professional		$85.11	$141.25	$234.42