Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $2,089.30 / $10,715.19	Facility		$93.33	$2,089.30	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $97.72 / $218.78	Professional		$60.26	$97.72	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $83.18	Professional		$40.74	$40.74	$83.18
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 $58.88 / $87.10 / $141.25	Professional		$58.88	$87.10	$141.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
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 $67.61 / $104.71 / $181.97	Professional		$67.61	$104.71	$181.97
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 $64.57 / $102.33 / $165.96	Professional		$64.57	$102.33	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
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 $60.26 / $95.50 / $177.83	Professional		$60.26	$95.50	$177.83
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 $58.88 / $87.10 / $141.25	Professional		$58.88	$87.10	$141.25