Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.36 / $2,040.00 / $9,504.00	Facility		$205.36	$2,040.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.90 / $190.83 / $352.19	Professional		$109.90	$190.83	$352.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.11 / $197.11 / $197.11	Professional		$197.11	$197.11	$197.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,114.00 / $8,800.00	Facility		$918.00	$2,114.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.23 / $149.22 / $271.51	Professional		$88.23	$149.22	$271.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $107.20 / $128.63 / $159.22	Facility		$107.20	$128.63	$159.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $134.00 / $212.56 / $251.21	Professional		$134.00	$212.56	$251.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.17 / $292.23 / $581.00	Facility		$192.17	$292.23	$581.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.05 / $206.90 / $358.37	Professional		$118.05	$206.90	$358.37
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $192.17 / $366.00 / $581.00	Facility		$192.17	$366.00	$581.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.27 / $212.56 / $355.81	Professional		$123.27	$212.56	$355.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.21 / $202.65 / $289.54	Professional		$150.21	$202.65	$289.54
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 $151.94 / $214.70 / $395.38	Professional		$151.94	$214.70	$395.38