Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $579.70 / $3,324.00 / $8,293.39	Facility		$579.70	$3,324.00	$8,293.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.20 / $310.57 / $927.41	Professional		$164.20	$310.57	$927.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.82 / $187.13 / $229.23	Professional		$152.82	$187.13	$229.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.00 / $2,412.00 / $5,211.00	Facility		$891.00	$2,412.00	$5,211.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.99 / $216.25 / $519.11	Professional		$150.99	$216.25	$519.11
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $190.38 / $195.26 / $195.26	Professional		$190.38	$195.26	$195.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.72 / $195.26 / $244.08	Facility		$162.72	$195.26	$244.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $168.10 / $211.54 / $317.31	Professional		$168.10	$211.54	$317.31
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 $171.14 / $254.91 / $927.42	Professional		$171.14	$254.91	$927.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $857.35 / $1,913.92 / $5,166.95	Facility		$857.35	$1,913.92	$5,166.95
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $19.01 / $19.01 / $19.01	Facility	AS	$19.01	$19.01	$19.01
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $170.86 / $255.27 / $982.13	Professional		$170.86	$255.27	$982.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $166.53 / $216.49 / $302.45	Professional		$166.53	$216.49	$302.45
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $1,365.00 / $13,243.00	Facility		$480.00	$1,365.00	$13,243.00
United Facility/Professional Professional Modifier Low / Median / High Price $145.80 / $245.08 / $764.13	Professional		$145.80	$245.08	$764.13