Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.79 / $532.00 / $8,553.00	Facility		$162.79	$532.00	$8,553.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.83 / $175.97 / $333.81	Professional		$106.83	$175.97	$333.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.10 / $176.45 / $247.03	Professional		$144.10	$176.45	$247.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.39 / $137.69 / $245.35	Professional		$83.39	$137.69	$245.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.93 / $123.52 / $152.87	Facility		$102.93	$123.52	$152.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $138.33 / $184.86 / $184.86	Professional		$138.33	$184.86	$184.86
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 $120.42 / $173.34 / $297.49	Professional		$120.42	$173.34	$297.49
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $301.89 / $301.89 / $301.89	Facility		$301.89	$301.89	$301.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $125.33 / $178.28 / $308.86	Professional		$125.33	$178.28	$308.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.24 / $171.39 / $246.02	Professional		$123.24	$171.39	$246.02
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $124.22 / $186.53 / $326.86	Professional		$124.22	$186.53	$326.86