Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.62 / $1,939.08 / $3,704.30	Facility		$242.62	$1,939.08	$3,704.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.18 / $206.89 / $390.98	Professional		$144.18	$206.89	$390.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.54 / $165.80 / $165.80	Professional		$127.54	$165.80	$165.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,981.00 / $3,943.00	Facility		$937.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.68 / $174.60 / $281.79	Professional		$125.68	$174.60	$281.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.54 / $159.43 / $189.44	Facility		$127.54	$159.43	$189.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $167.85 / $198.37 / $353.02	Professional		$167.85	$198.37	$353.02
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 $140.76 / $199.80 / $292.47	Professional		$140.76	$199.80	$292.47
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $835.60 / $1,830.60 / $2,406.61	Facility		$835.60	$1,830.60	$2,406.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $152.59 / $203.19 / $296.08	Professional		$152.59	$203.19	$296.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.59 / $152.37 / $205.16	Professional		$115.59	$152.37	$205.16
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $4,132.00	Facility		$1,020.00	$1,940.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $210.81 / $342.56	Professional		$163.19	$210.81	$342.56