Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.34 / $1,902.00 / $9,516.00	Facility		$111.34	$1,902.00	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.93 / $100.80 / $195.61	Professional		$67.93	$100.80	$195.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.75 / $102.75 / $102.75	Professional		$102.75	$102.75	$102.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,927.00 / $3,943.00	Facility		$814.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $82.96 / $132.07	Professional		$63.25	$82.96	$132.07
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $126.55 / $126.55 / $129.79	Professional		$126.55	$126.55	$129.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.89 / $88.42 / $117.44	Facility		$68.89	$88.42	$117.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $118.98 / $151.41 / $127,498.73	Professional		$118.98	$151.41	$127,498.73
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 $86.20 / $129.56 / $194.68	Professional		$86.20	$129.56	$194.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $131.76 / $410.07 / $983.83	Facility		$131.76	$410.07	$983.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.68 / $129.94 / $194.96	Professional		$87.68	$129.94	$194.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.46 / $104.97 / $150.61	Professional		$78.46	$104.97	$150.61
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $965.00 / $2,914.00	Facility		$444.00	$965.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $84.24 / $131.16 / $206.47	Professional		$84.24	$131.16	$206.47