Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $249.87 / $1,949.00 / $4,215.00	Facility		$249.87	$1,949.00	$4,215.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $194.24 / $574.62	Professional		$72.56	$194.24	$574.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.19 / $153.28 / $153.28	Professional		$102.19	$153.28	$153.28
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 $83.52 / $291.81 / $666.80	Professional		$83.52	$291.81	$666.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.61 / $98.26 / $116.75	Facility		$78.61	$98.26	$116.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $349.67 / $413.24 / $708.49	Professional		$349.67	$413.24	$708.49
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 $94.33 / $317.88 / $731.13	Professional		$94.33	$317.88	$731.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $499.26 / $1,260.10 / $1,791.66	Facility		$499.26	$1,260.10	$1,791.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $317.88 / $732.60	Professional		$95.90	$317.88	$732.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $311.45 / $422.63 / $580.68	Professional		$311.45	$422.63	$580.68
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,952.00 / $4,132.00	Facility		$1,020.00	$1,952.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $382.92 / $585.98 / $914.80	Professional		$382.92	$585.98	$914.80