Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $707.95 / $9,549.93	Facility		$169.82	$707.95	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $371.54	Professional		$117.49	$165.96	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
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 $67.61 / $87.10 / $173.78	Professional		$67.61	$87.10	$173.78
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $177.83	Professional		$151.36	$151.36	$177.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $144.54	Facility		$123.03	$123.03	$144.54
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 $123.03 / $173.78 / $257.04	Professional		$123.03	$173.78	$257.04
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $380.19 / $21,379.62	Facility		$251.19	$380.19	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $257.04	Professional		$117.49	$173.78	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
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 $131.83 / $165.96 / $295.12	Professional		$131.83	$165.96	$295.12
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 $95.50 / $144.54 / $229.09	Professional		$95.50	$144.54	$229.09