Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.58 / $1,654.24 / $8,553.00	Facility		$126.58	$1,654.24	$8,553.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.90 / $144.77 / $285.19	Professional		$72.90	$144.77	$285.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.07 / $140.19 / $164.93	Professional		$125.07	$140.19	$164.93
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 $60.13 / $108.68 / $215.77	Professional		$60.13	$108.68	$215.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.14 / $88.93 / $105.67	Facility		$71.14	$88.93	$105.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.18 / $178.67 / $311.69	Professional		$151.18	$178.67	$311.69
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 $85.36 / $147.37 / $255.01	Professional		$85.36	$147.37	$255.01
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $808.50 / $1,058.82 / $1,590.59	Facility		$808.50	$1,058.82	$1,590.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $86.79 / $152.22 / $259.13	Professional		$86.79	$152.22	$259.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $153.74 / $209.77	Professional		$112.90	$153.74	$209.77
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 $122.08 / $174.33 / $292.01	Professional		$122.08	$174.33	$292.01