Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $687.43 / $3,742.00 / $9,516.00	Facility		$687.43	$3,742.00	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $430.86 / $607.63 / $1,073.06	Professional		$430.86	$607.63	$1,073.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $214.79 / $420.83 / $617.91	Professional		$214.79	$420.83	$617.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,576.00 / $14,996.00	Facility		$1,760.00	$3,576.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $393.15 / $543.21 / $911.96	Professional		$393.15	$543.21	$911.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $414.18 / $531.58 / $706.01	Facility		$414.18	$531.58	$706.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $665.24 / $846.66 / $127,498.73	Professional		$665.24	$846.66	$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 $509.43 / $714.11 / $1,112.79	Professional		$509.43	$714.11	$1,112.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $795.21 / $795.21 / $795.21	Facility		$795.21	$795.21	$795.21
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $79.52 / $79.52 / $79.52	Facility	AS	$79.52	$79.52	$79.52
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $518.29 / $725.71 / $1,149.04	Professional		$518.29	$725.71	$1,149.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.37 / $457.98 / $783.81	Professional		$72.37	$457.98	$783.81
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,625.00 / $7,847.00	Facility		$2,840.00	$5,625.00	$7,847.00
United Facility/Professional Professional Modifier Low / Median / High Price $513.54 / $782.47 / $1,300.58	Professional		$513.54	$782.47	$1,300.58