Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $1,621.81 / $4,786.30	Facility		$323.59	$1,621.81	$4,786.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $194.98 / $977.24	Professional		$67.61	$194.98	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $72.44 / $338.84	Professional		$63.10	$72.44	$338.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $331.13 / $758.58	Professional		$79.43	$331.13	$758.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $77.62 / $87.10	Facility		$72.44	$77.62	$87.10
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 $85.11 / $354.81 / $776.25	Professional		$85.11	$354.81	$776.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,659.59 / $4,570.88	Facility		$912.01	$1,659.59	$4,570.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $354.81 / $776.25	Professional		$87.10	$354.81	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $58.88	Professional		$32.36	$33.11	$58.88
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $346.74 / $776.25	Professional		$67.61	$346.74	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $316.23 / $758.58	Professional		$75.86	$316.23	$758.58