Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $1,230.27 / $9,120.11	Facility		$177.83	$1,230.27	$9,120.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $186.21 / $407.38	Professional		$107.15	$186.21	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $281.84	Professional		$131.83	$147.91	$281.84
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 $95.50 / $144.54 / $251.19	Professional		$95.50	$144.54	$251.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $120.23 / $141.25	Facility		$102.33	$120.23	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $204.17 / $234.42	Professional		$181.97	$204.17	$234.42
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 $120.23 / $181.97 / $281.84	Professional		$120.23	$181.97	$281.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $691.83 / $21,379.62	Facility		$426.58	$691.83	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $186.21 / $302.00	Professional		$123.03	$186.21	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
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 / $162.18 / $281.84	Professional		$104.71	$162.18	$281.84
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 $104.71 / $154.88 / $251.19	Professional		$104.71	$154.88	$251.19