Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $467.74 / $6,606.93	Facility		$79.43	$467.74	$6,606.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $89.13 / $257.04	Professional		$47.86	$89.13	$257.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $91.20	Professional		$47.86	$66.07	$91.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $77.62 / $128.82	Professional		$47.86	$77.62	$128.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
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 $56.23 / $91.20 / $154.88	Professional		$56.23	$91.20	$154.88
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $251.19 / $407.38	Facility		$87.10	$251.19	$407.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $87.10 / $144.54	Professional		$53.70	$87.10	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $33.11 / $45.71	Professional		$30.90	$33.11	$45.71
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $245.47	Facility		$100.00	$100.00	$245.47
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $91.20 / $138.04	Professional		$54.95	$91.20	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $74.13 / $120.23	Professional		$46.77	$74.13	$120.23