Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $1,862.09 / $10,232.93	Facility		$117.49	$1,862.09	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $144.54 / $288.40	Professional		$75.86	$144.54	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $120.23	Professional		$81.28	$102.33	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $223.87	Professional		$74.13	$134.90	$223.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $75.86 / $87.10	Facility		$72.44	$75.86	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $125.89 / $21,379.62	Facility		$64.57	$125.89	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $263.03	Professional		$85.11	$154.88	$263.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $229.09 / $21,379.62	Facility		$173.78	$229.09	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $154.88 / $263.03	Professional		$87.10	$154.88	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $41.69	Professional		$32.36	$33.11	$41.69
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $158.49	Facility		$100.00	$100.00	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $154.88 / $275.42	Professional		$69.18	$154.88	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $912.01 / $2,951.21	Facility		$309.03	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $223.87	Professional		$77.62	$128.82	$223.87