Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.58 / $636.75 / $4,275.00	Facility		$114.58	$636.75	$4,275.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.66 / $112.91 / $233.10	Professional		$64.66	$112.91	$233.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $64.09 / $121.37	Professional		$64.09	$64.09	$121.37
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 $66.94 / $99.88 / $171.23	Professional		$66.94	$99.88	$171.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.83 / $78.54 / $93.32	Facility		$62.83	$78.54	$93.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.25 / $131.47 / $232.60	Professional		$111.25	$131.47	$232.60
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 $76.70 / $122.15 / $200.48	Professional		$76.70	$122.15	$200.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $86.20 / $576.44 / $1,701.09	Facility		$86.20	$576.44	$1,701.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $131.47 / $201.75	Professional		$78.54	$131.47	$201.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.34 / $115.47 / $157.15	Professional		$85.34	$115.47	$157.15
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 $89.27 / $131.28 / $242.35	Professional		$89.27	$131.28	$242.35