Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $2,511.89 / $10,715.19	Facility		$169.82	$2,511.89	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $416.87	Professional		$109.65	$158.49	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $275.42	Professional		$186.21	$186.21	$275.42
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 $97.72 / $147.91 / $263.03	Professional		$97.72	$147.91	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $112.20 / $128.82	Facility		$107.15	$112.20	$128.82
Cigna 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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $295.12	Professional		$125.89	$186.21	$295.12
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 $128.82 / $194.98 / $309.03	Professional		$128.82	$194.98	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $72.44	Professional		$32.36	$33.11	$72.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $371.54	Facility		$100.00	$100.00	$371.54
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $323.59	Professional		$104.71	$169.82	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $263.03	Professional		$109.65	$158.49	$263.03