Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.22 / $372.42 / $1,487.51	Facility		$120.22	$372.42	$1,487.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.76 / $133.24 / $238.88	Professional		$105.76	$133.24	$238.88
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 $96.26 / $130.16 / $212.27	Professional		$96.26	$130.16	$212.27
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $137.58 / $137.58 / $137.58	Professional		$137.58	$137.58	$137.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.96 / $127.00 / $168.66	Facility		$98.96	$127.00	$168.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $150.44 / $191.48 / $127,498.73	Professional		$150.44	$191.48	$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 $120.66 / $173.56 / $259.86	Professional		$120.66	$173.56	$259.86
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $187.17 / $249.04 / $299.98	Facility		$187.17	$249.04	$299.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $121.69 / $176.43 / $260.79	Professional		$121.69	$176.43	$260.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $143.34 / $202.87	Professional		$109.37	$143.34	$202.87
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $979.00 / $3,398.00	Facility		$480.00	$979.00	$3,398.00
United Facility/Professional Professional Modifier Low / Median / High Price $111.25 / $173.02 / $282.88	Professional		$111.25	$173.02	$282.88