Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $407.38 / $10,232.93	Facility		$208.93	$407.38	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $467.74	Professional		$173.78	$245.47	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $213.80	Professional		$154.88	$154.88	$213.80
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 $131.83 / $181.97 / $302.00	Professional		$131.83	$181.97	$302.00
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $223.87	Facility		$190.55	$190.55	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $295.12 / $21,379.62	Facility		$181.97	$295.12	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $354.81	Professional		$181.97	$251.19	$354.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $257.04 / $549.54	Facility		$165.96	$257.04	$549.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $354.81	Professional		$177.83	$251.19	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $302.00	Facility		$100.00	$100.00	$302.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $457.09	Professional		$204.17	$239.88	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $323.59	Professional		$134.90	$194.98	$323.59