Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $2,089.30 / $10,715.19	Facility		$257.04	$2,089.30	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $457.09	Professional		$169.82	$239.88	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $158.49	Professional		$151.36	$151.36	$158.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,754.23 / $7,943.28	Facility		$1,000.00	$2,754.23	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $436.52	Professional		$141.25	$223.87	$436.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $169.82 / $190.55	Facility		$158.49	$169.82	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $269.15 / $21,379.62	Facility		$138.04	$269.15	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $407.38	Professional		$173.78	$251.19	$407.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $416.87	Professional		$173.78	$251.19	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $2,041.74	Facility		$100.00	$100.00	$2,041.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $257.04 / $467.74	Professional		$165.96	$257.04	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $5,248.07	Facility		$1,698.24	$2,570.40	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $380.19	Professional		$154.88	$229.09	$380.19