Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $2,570.40 / $10,715.19	Facility		$141.25	$2,570.40	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $138.04 / $380.19	Professional		$81.28	$138.04	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
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 $83.18 / $123.03 / $204.17	Professional		$83.18	$123.03	$204.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
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 $93.33 / $151.36 / $275.42	Professional		$93.33	$151.36	$275.42
Medical Mutual of Ohio 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
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $245.47	Professional		$89.13	$147.91	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
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 $83.18 / $144.54 / $251.19	Professional		$83.18	$144.54	$251.19
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 $81.28 / $128.82 / $208.93	Professional		$81.28	$128.82	$208.93