Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $3,019.95 / $10,715.19	Facility		$199.53	$3,019.95	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $173.78 / $457.09	Professional		$70.79	$173.78	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $107.15 / $194.98	Professional		$63.10	$107.15	$194.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $2,137.96 / $3,981.07	Facility		$602.56	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $138.04 / $263.03	Professional		$69.18	$138.04	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $77.62 / $630.96	Facility		$69.18	$77.62	$630.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $85.11	Professional		$75.86	$75.86	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $457.09 / $758.58	Facility		$61.66	$457.09	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $194.98 / $363.08	Professional		$79.43	$194.98	$363.08
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $562.34 / $1,023.29	Facility		$123.03	$562.34	$1,023.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $194.98 / $354.81	Professional		$77.62	$194.98	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $54.95	Professional		$32.36	$33.11	$54.95
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,122.02	Facility		$100.00	$100.00	$1,122.02
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $194.98 / $457.09	Professional		$72.44	$194.98	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,398.83 / $4,897.79	Facility		$676.08	$2,398.83	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $147.91 / $288.40	Professional		$67.61	$147.91	$288.40