Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $2,089.30 / $10,232.93	Facility		$120.23	$2,089.30	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $144.54 / $371.54	Professional		$75.86	$144.54	$371.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $93.33 / $93.33 / $93.33	Professional	52	$93.33	$93.33	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $134.90	Professional		$97.72	$114.82	$134.90
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 $66.07 / $104.71 / $177.83	Professional		$66.07	$104.71	$177.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $245.47	Professional		$114.82	$141.25	$245.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $100.00 / $107.15	Facility		$63.10	$100.00	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $281.84	Professional		$128.82	$162.18	$281.84
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 $81.28 / $128.82 / $234.42	Professional		$81.28	$128.82	$234.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $21,379.62	Facility		$169.82	$169.82	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $223.87	Professional		$79.43	$128.82	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $63.10	Professional		$32.36	$33.11	$63.10
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 $75.86 / $128.82 / $213.80	Professional		$75.86	$128.82	$213.80
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 $69.18 / $109.65 / $186.21	Professional		$69.18	$109.65	$186.21