Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.55 / $1,967.00 / $10,265.78	Facility		$161.55	$1,967.00	$10,265.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.60 / $161.55 / $279.50	Professional		$110.60	$161.55	$279.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.96 / $186.96 / $186.96	Professional		$186.96	$186.96	$186.96
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 $90.91 / $148.46 / $260.41	Professional		$90.91	$148.46	$260.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $107.77 / $129.32 / $160.07	Facility		$107.77	$129.32	$160.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $156.78 / $171.38 / $171.38	Professional		$156.78	$171.38	$171.38
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 $129.32 / $190.95 / $303.70	Professional		$129.32	$190.95	$303.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $131.47 / $198.43 / $303.70	Professional		$131.47	$198.43	$303.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $143.14 / $194.73 / $260.38	Professional		$143.14	$194.73	$260.38
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 $141.58 / $196.07 / $326.55	Professional		$141.58	$196.07	$326.55