Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.49 / $2,113.00 / $9,534.00	Facility		$200.49	$2,113.00	$9,534.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.24 / $182.49 / $316.42	Professional		$124.24	$182.49	$316.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $198.59 / $198.59 / $198.59	Professional		$198.59	$198.59	$198.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $711.00 / $1,640.00 / $3,943.00	Facility		$711.00	$1,640.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.46 / $159.56 / $274.20	Professional		$106.46	$159.56	$274.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $119.07 / $142.88 / $176.85	Facility		$119.07	$142.88	$176.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $148.84 / $206.82 / $244.43	Professional		$148.84	$206.82	$244.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.62 / $456.00 / $600.00	Facility		$213.62	$456.00	$600.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.22 / $210.60 / $360.00	Professional		$135.22	$210.60	$360.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $213.62 / $456.00 / $581.00	Facility		$213.62	$456.00	$581.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $140.16 / $219.04 / $361.61	Professional		$140.16	$219.04	$361.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.30 / $185.45 / $279.69	Professional		$122.30	$185.45	$279.69
United Facility/Professional Facility Modifier Low / Median / High Price $135.00 / $876.00 / $3,218.00	Facility		$135.00	$876.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $161.09 / $223.59 / $404.21	Professional		$161.09	$223.59	$404.21