Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.95 / $2,816.00 / $9,516.00	Facility		$200.95	$2,816.00	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.47 / $152.61 / $325.70	Professional		$70.47	$152.61	$325.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.91 / $66.91 / $156.62	Professional		$66.91	$66.91	$156.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $711.00 / $1,769.00 / $3,943.00	Facility		$711.00	$1,769.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.98 / $138.91 / $256.33	Professional		$68.98	$138.91	$256.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.52 / $82.22 / $101.77	Facility		$68.52	$82.22	$101.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.65 / $205.35 / $242.68	Professional		$85.65	$205.35	$242.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.26 / $581.00 / $1,024.26	Facility		$123.26	$581.00	$1,024.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.80 / $194.89 / $336.03	Professional		$78.80	$194.89	$336.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $456.00 / $581.00 / $763.03	Facility		$456.00	$581.00	$763.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $82.22 / $196.02 / $336.03	Professional		$82.22	$196.02	$336.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $160.59 / $222.35 / $309.63	Professional		$160.59	$222.35	$309.63
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 $166.38 / $227.15 / $403.37	Professional		$166.38	$227.15	$403.37