Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.80 / $2,895.00 / $10,268.00	Facility		$201.80	$2,895.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.71 / $188.99 / $398.35	Professional		$135.71	$188.99	$398.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.35 / $125.80 / $165.53	Professional		$94.35	$125.80	$165.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,405.00 / $14,996.00	Facility		$1,760.00	$3,405.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $254.95 / $404.73	Professional		$182.45	$254.95	$404.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.82 / $135.07 / $196.68	Facility		$123.82	$135.07	$196.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $145.66 / $145.66 / $203.58	Professional		$145.66	$145.66	$203.58
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 $145.66 / $211.78 / $371.31	Professional		$145.66	$211.78	$371.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $159.68 / $159.68 / $1,149.04	Facility		$159.68	$159.68	$1,149.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $145.66 / $211.78 / $379.06	Professional		$145.66	$211.78	$379.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.89 / $143.53 / $198.68	Professional		$109.89	$143.53	$198.68
United Facility/Professional Facility Modifier Low / Median / High Price $2,233.00 / $4,223.00 / $6,522.00	Facility		$2,233.00	$4,223.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.11 / $211.36 / $340.18	Professional		$126.11	$211.36	$340.18