Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.73 / $1,866.00 / $8,956.00	Facility		$284.73	$1,866.00	$8,956.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.39 / $260.98 / $491.56	Professional		$117.39	$260.98	$491.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $102.34 / $174.31	Professional		$67.48	$102.34	$174.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,386.00 / $8,800.00	Facility		$918.00	$2,386.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.74 / $220.49 / $408.28	Professional		$126.74	$220.49	$408.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.46 / $134.94 / $167.02	Facility		$112.46	$134.94	$167.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $140.58 / $294.86 / $348.47	Professional		$140.58	$294.86	$348.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.46 / $577.00 / $959.43	Facility		$202.46	$577.00	$959.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.58 / $260.00 / $491.21	Professional		$131.58	$260.00	$491.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $366.00 / $577.00 / $1,255.63	Facility		$366.00	$577.00	$1,255.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.94 / $266.56 / $488.85	Professional		$134.94	$266.56	$488.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $242.98 / $335.32 / $467.08	Professional		$242.98	$335.32	$467.08
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 $247.55 / $348.10 / $595.11	Professional		$247.55	$348.10	$595.11