Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.44 / $1,883.00 / $9,516.00	Facility		$164.44	$1,883.00	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.89 / $178.59 / $307.95	Professional		$111.89	$178.59	$307.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $172.06 / $176.92	Professional		$161.00	$172.06	$176.92
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 $104.38 / $155.47 / $272.07	Professional		$104.38	$155.47	$272.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.04 / $170.42 / $170.42	Facility		$117.04	$170.42	$170.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.16 / $194.61 / $194.61	Professional		$155.16	$194.61	$194.61
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 $112.45 / $185.77 / $318.89	Professional		$112.45	$185.77	$318.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $116.23 / $194.61 / $309.61	Professional		$116.23	$194.61	$309.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $124.79 / $184.91 / $269.15	Professional		$124.79	$184.91	$269.15
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 $146.13 / $196.69 / $325.22	Professional		$146.13	$196.69	$325.22