Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $724.44 / $10,715.19	Facility		$138.04	$724.44	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $407.38	Professional		$112.20	$147.91	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
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 $123.03 / $158.49 / $275.42	Professional		$123.03	$158.49	$275.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $128.82 / $151.36	Facility		$125.89	$128.82	$151.36
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 $134.90 / $194.98 / $295.12	Professional		$134.90	$194.98	$295.12
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $21,379.62	Facility		$1,230.27	$1,230.27	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $316.23	Professional		$134.90	$199.53	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,122.02	Facility		$100.00	$100.00	$1,122.02
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $338.84	Professional		$120.23	$169.82	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,073.80	Facility		$954.99	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $269.15	Professional		$120.23	$165.96	$269.15