Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.77 / $2,654.12 / $5,196.39	Facility		$202.77	$2,654.12	$5,196.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.87 / $202.47 / $347.75	Professional		$84.87	$202.47	$347.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $83.62 / $83.62	Professional		$83.62	$83.62	$83.62
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 $97.62 / $198.25 / $359.87	Professional		$97.62	$198.25	$359.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.88 / $110.26 / $172.28	Facility		$91.88	$110.26	$172.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $239.48 / $264.07 / $424.53	Professional		$239.48	$264.07	$424.53
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 $110.26 / $234.70 / $423.56	Professional		$110.26	$234.70	$423.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $812.30 / $2,205.83 / $3,676.28	Facility		$812.30	$2,205.83	$3,676.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $234.70 / $424.35	Professional		$113.94	$234.70	$424.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.91 / $269.27 / $366.93	Professional		$199.91	$269.27	$366.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,665.00 / $5,268.00	Facility		$1,689.00	$2,665.00	$5,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $207.11 / $304.16 / $517.04	Professional		$207.11	$304.16	$517.04