Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.75 / $1,000.24 / $9,504.00	Facility		$141.75	$1,000.24	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.29 / $160.85 / $275.63	Professional		$101.29	$160.85	$275.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.13 / $147.47 / $182.30	Professional		$129.13	$147.47	$182.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.25 / $158.16 / $265.83	Professional		$106.25	$158.16	$265.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $171.66 / $171.66 / $178.53	Professional		$171.66	$171.66	$178.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.39 / $115.49 / $137.22	Facility		$92.39	$115.49	$137.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $167.10 / $205.08 / $250.18	Professional		$167.10	$205.08	$250.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.54 / $165.34 / $279.69	Professional		$90.54	$165.34	$279.69
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $327.90 / $327.90 / $327.90	Facility		$327.90	$327.90	$327.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $101.63 / $174.70 / $297.60	Professional		$101.63	$174.70	$297.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.90 / $145.95 / $209.48	Professional		$108.90	$145.95	$209.48
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $975.00 / $2,914.00	Facility		$444.00	$975.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $124.07 / $170.13 / $268.43	Professional		$124.07	$170.13	$268.43