Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.61 / $2,113.00 / $10,268.00	Facility		$153.61	$2,113.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.03 / $165.18 / $263.44	Professional		$102.03	$165.18	$263.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.80 / $198.27 / $198.27	Professional		$127.80	$198.27	$198.27
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 $99.28 / $145.49 / $251.93	Professional		$99.28	$145.49	$251.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $113.53 / $165.30 / $165.30	Facility		$113.53	$165.30	$165.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $146.75 / $181.75 / $181.75	Professional		$146.75	$181.75	$181.75
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 $109.07 / $175.26 / $300.00	Professional		$109.07	$175.26	$300.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $116.87 / $185.98 / $289.14	Professional		$116.87	$185.98	$289.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.45 / $163.91 / $241.21	Professional		$117.45	$163.91	$241.21
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 $136.96 / $182.61 / $302.22	Professional		$136.96	$182.61	$302.22