Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $2,511.89 / $9,120.11	Facility		$218.78	$2,511.89	$9,120.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $213.80 / $549.54	Professional		$85.11	$213.80	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $162.18	Professional		$151.36	$151.36	$162.18
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 $100.00 / $223.87 / $398.11	Professional		$100.00	$223.87	$398.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $100.00 / $112.20	Facility		$93.33	$100.00	$112.20
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 $109.65 / $234.42 / $457.09	Professional		$109.65	$234.42	$457.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $851.14 / $21,379.62	Facility		$776.25	$851.14	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $234.42 / $457.09	Professional		$112.20	$234.42	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $74.13	Professional		$32.36	$33.11	$74.13
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $870.96	Facility		$100.00	$100.00	$870.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $245.47 / $467.74	Professional		$87.10	$245.47	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,073.80	Facility		$954.99	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $213.80 / $436.52	Professional		$95.50	$213.80	$436.52