Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $5,128.61 / $11,481.54	Facility		$223.87	$5,128.61	$11,481.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $295.12 / $630.96	Professional		$169.82	$295.12	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,949.84 / $3,981.07	Facility		$602.56	$1,949.84	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $158.49 / $331.13	Professional		$87.10	$158.49	$331.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $194.98 / $302.00	Facility		$169.82	$194.98	$302.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $213.80	Professional		$190.55	$190.55	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $302.00 / $575.44	Facility		$34.67	$302.00	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $549.54	Professional		$154.88	$275.42	$549.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $331.13 / $575.44	Facility		$302.00	$331.13	$575.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $275.42 / $512.86	Professional		$165.96	$275.42	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $89.13	Professional		$32.36	$33.11	$89.13
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,148.15	Facility		$100.00	$100.00	$1,148.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $346.74 / $660.69	Professional		$190.55	$346.74	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $1,737.80 / $3,981.07	Facility		$489.78	$1,737.80	$3,981.07
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $229.09 / $416.87	Professional		$128.82	$229.09	$416.87