Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.42 / $1,349.84 / $4,275.00	Facility		$102.42	$1,349.84	$4,275.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $100.31 / $182.99	Professional		$57.66	$100.31	$182.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.96 / $93.94 / $110.51	Professional		$50.96	$93.94	$110.51
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 $57.12 / $83.93 / $146.13	Professional		$57.12	$83.93	$146.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $70.00 / $83.17	Facility		$56.00	$70.00	$83.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.25 / $114.93 / $202.92	Professional		$97.25	$114.93	$202.92
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 $68.31 / $108.41 / $177.60	Professional		$68.31	$108.41	$177.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $909.13 / $1,373.13 / $2,534.10	Facility		$909.13	$1,373.13	$2,534.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.98 / $110.51 / $183.77	Professional		$69.98	$110.51	$183.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.34 / $115.47 / $157.15	Professional		$85.34	$115.47	$157.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,952.00 / $4,132.00	Facility		$1,020.00	$1,952.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.76 / $117.29 / $187.50	Professional		$79.76	$117.29	$187.50