Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $2,570.40 / $10,715.19	Facility		$151.36	$2,570.40	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $144.54 / $478.63	Professional		$91.20	$144.54	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $154.88	Professional		$147.91	$147.91	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $223.87	Professional		$91.20	$141.25	$223.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $112.20 / $21,379.62	Facility		$72.44	$112.20	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $147.91 / $251.19	Professional		$95.50	$147.91	$251.19
Medical Mutual of Ohio 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
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $151.36 / $239.88	Professional		$95.50	$151.36	$239.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $147.91 / $269.15	Professional		$87.10	$147.91	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $154.88 / $263.03	Professional		$93.33	$154.88	$263.03