Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.78 / $1,179.50 / $6,048.90	Facility		$129.78	$1,179.50	$6,048.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.34 / $93.50 / $214.61	Professional		$47.34	$93.50	$214.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $99.07 / $131.37	Professional		$43.50	$99.07	$131.37
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 $53.15 / $88.65 / $150.46	Professional		$53.15	$88.65	$150.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.80 / $59.75 / $71.00	Facility		$47.80	$59.75	$71.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.98 / $128.79 / $224.09	Professional		$108.98	$128.79	$224.09
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 $58.31 / $100.00 / $169.54	Professional		$58.31	$100.00	$169.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $212.41 / $695.55 / $3,691.51	Facility		$212.41	$695.55	$3,691.51
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $59.75 / $100.93 / $170.74	Professional		$59.75	$100.93	$170.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.14 / $78.82 / $152.52	Professional		$52.14	$78.82	$152.52
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $1,017.00 / $3,398.00	Facility		$480.00	$1,017.00	$3,398.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.76 / $110.00 / $187.66	Professional		$74.76	$110.00	$187.66