Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.30 / $2,547.00 / $10,635.00	Facility		$109.30	$2,547.00	$10,635.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.50 / $118.85 / $248.92	Professional		$73.50	$118.85	$248.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $74.98 / $74.98	Professional		$74.98	$74.98	$74.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,426.00 / $12,098.50 / $21,233.00	Facility		$4,426.00	$12,098.50	$21,233.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.55 / $165.92	Professional		$69.18	$97.55	$165.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.42 / $89.28 / $106.08	Facility		$71.42	$89.28	$106.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.56 / $92.85 / $168.95	Professional		$78.56	$92.85	$168.95
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 $71.42 / $108.05 / $155.41	Professional		$71.42	$108.05	$155.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $110.31 / $152.19	Professional		$74.98	$110.31	$152.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.28 / $78.50 / $105.09	Professional		$58.28	$78.50	$105.09
United Facility/Professional Facility Modifier Low / Median / High Price $1,480.00 / $3,086.00 / $6,111.00	Facility		$1,480.00	$3,086.00	$6,111.00
United Facility/Professional Professional Modifier Low / Median / High Price $71.89 / $97.01 / $163.69	Professional		$71.89	$97.01	$163.69