Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,089.30 / $8,912.51	Facility		$426.58	$2,089.30	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $467.74 / $1,548.82	Professional		$245.47	$467.74	$1,548.82
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $23.99 / $57.54 / $154.88	Professional	AS	$23.99	$57.54	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $251.19 / $426.58	Professional		$213.80	$251.19	$426.58
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $28.84 / $38.90 / $54.95	Professional	AS	$28.84	$38.90	$54.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $309.03 / $478.63	Professional		$234.42	$309.03	$478.63
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $33.11 / $42.66 / $67.61	Professional	AS	$33.11	$42.66	$67.61
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $407.38	Professional		$269.15	$316.23	$407.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $316.23 / $407.38	Facility		$245.47	$316.23	$407.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $331.13 / $588.84	Professional		$245.47	$331.13	$588.84
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 $245.47 / $363.08 / $537.03	Professional		$245.47	$363.08	$537.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $2,511.89 / $5,495.41	Facility		$912.01	$2,511.89	$5,495.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $354.81 / $549.54	Professional		$229.09	$354.81	$549.54
Medical Mutual of Ohio Facility/Professional Professional Modifier AS Low / Median / High Price $10.72 / $10.96 / $41.69	Professional	AS	$10.72	$10.96	$41.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $53.70	Professional		$32.36	$33.11	$53.70
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 $234.42 / $316.23 / $512.86	Professional		$234.42	$316.23	$512.86
SummaCare Facility/Professional Professional Modifier AS Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	AS	$66.07	$66.07	$66.07
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 $204.17 / $309.03 / $478.63	Professional		$204.17	$309.03	$478.63