Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $903.52 / $10,635.00	Facility		$94.22	$903.52	$10,635.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.36 / $117.08 / $209.95	Professional		$63.36	$117.08	$209.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.03 / $84.03 / $84.03	Professional		$84.03	$84.03	$84.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $102.14 / $197.43	Professional		$56.28	$102.14	$197.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.22 / $76.25 / $90.60	Facility		$62.22	$76.25	$90.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.41 / $127.71 / $145.13	Professional		$95.41	$127.71	$145.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.76 / $109.76 / $21,571.00	Facility		$109.76	$109.76	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.04 / $121.65 / $236.78	Professional		$67.04	$121.65	$236.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $109.76 / $127.95 / $500.14	Facility		$109.76	$127.95	$500.14
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $116.37 / $215.04	Professional		$67.09	$116.37	$215.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.97 / $145.95 / $203.88	Professional		$109.97	$145.95	$203.88
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $1,009.00 / $3,218.00	Facility		$444.00	$1,009.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $108.59 / $148.55 / $307.66	Professional		$108.59	$148.55	$307.66