Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.91 / $315.52 / $3,443.00	Facility		$61.91	$315.52	$3,443.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $72.15 / $168.99	Professional		$32.47	$72.15	$168.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.18 / $40.18 / $40.18	Professional		$40.18	$40.18	$40.18
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 $27.51 / $55.65 / $107.57	Professional		$27.51	$55.65	$107.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.26 / $83.48 / $161.35	Professional	50	$41.26	$83.48	$161.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.01 / $43.76 / $51.99	Facility		$35.01	$43.76	$51.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $103.36 / $126.09	Professional		$79.81	$103.36	$126.09
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 $32.90 / $71.59 / $130.90	Professional		$32.90	$71.59	$130.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $145.69 / $292.64 / $498.86	Facility		$145.69	$292.64	$498.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $76.56 / $135.32	Professional		$36.76	$76.56	$135.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $110.13 / $155.52	Professional		$81.79	$110.13	$155.52
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 $63.49 / $87.34 / $142.80	Professional		$63.49	$87.34	$142.80