Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $2,089.30 / $10,715.19	Facility		$33.88	$2,089.30	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $29.51 / $83.18	Professional		$20.89	$29.51	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $18.20	Professional		$18.20	$18.20	$18.20
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 $24.55 / $33.88 / $53.70	Professional		$24.55	$33.88	$53.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $23.99	Facility		$23.99	$23.99	$23.99
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 $23.44 / $36.31 / $60.26	Professional		$23.44	$36.31	$60.26
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 $22.91 / $36.31 / $57.54	Professional		$22.91	$36.31	$57.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $32.36 / $33.11	Professional		$12.02	$32.36	$33.11
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 $22.91 / $34.67 / $64.57	Professional		$22.91	$34.67	$64.57
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 $22.91 / $33.11 / $53.70	Professional		$22.91	$33.11	$53.70