Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.47 / $3,696.00 / $9,519.00	Facility		$360.47	$3,696.00	$9,519.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.42 / $360.22 / $610.03	Professional		$198.42	$360.22	$610.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $178.68 / $178.68 / $244.50	Professional		$178.68	$178.68	$244.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,576.00 / $14,996.00	Facility		$1,760.00	$3,576.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $270.68 / $524.99	Professional		$186.21	$270.68	$524.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $188.08 / $225.70 / $279.35	Facility		$188.08	$225.70	$279.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.19 / $355.03 / $355.03	Professional		$275.19	$355.03	$355.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.89 / $350.70 / $625.51	Professional		$206.89	$350.70	$625.51
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,016.71 / $4,046.75 / $8,896.73	Facility		$1,016.71	$4,046.75	$8,896.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $216.30 / $355.98 / $625.51	Professional		$216.30	$355.98	$625.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $317.71 / $429.70 / $579.24	Professional		$317.71	$429.70	$579.24
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,998.00 / $7,847.00	Facility		$2,840.00	$5,998.00	$7,847.00
United Facility/Professional Professional Modifier Low / Median / High Price $300.02 / $404.06 / $734.39	Professional		$300.02	$404.06	$734.39