Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.69 / $1,866.00 / $8,956.00	Facility		$205.69	$1,866.00	$8,956.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.02 / $205.69 / $430.26	Professional		$107.02	$205.69	$430.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.10 / $173.10 / $229.49	Professional		$173.10	$173.10	$229.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,118.00 / $8,800.00	Facility		$918.00	$2,118.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $136.22 / $268.70	Professional		$75.48	$136.22	$268.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.66 / $121.99 / $150.99	Facility		$101.66	$121.99	$150.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $127.08 / $210.36 / $248.61	Professional		$127.08	$210.36	$248.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.76 / $577.00 / $1,337.58	Facility		$181.76	$577.00	$1,337.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.62 / $205.30 / $363.36	Professional		$114.62	$205.30	$363.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $500.00 / $1,337.58	Facility		$379.00	$500.00	$1,337.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $116.94 / $211.92 / $376.13	Professional		$116.94	$211.92	$376.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $169.71 / $270.75	Professional		$32.34	$169.71	$270.75
United Facility/Professional Facility Modifier Low / Median / High Price $675.00 / $2,499.00 / $5,235.00	Facility		$675.00	$2,499.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $170.60 / $237.00 / $430.90	Professional		$170.60	$237.00	$430.90