Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.66 / $493.72 / $1,492.01	Facility		$83.66	$493.72	$1,492.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.87 / $600.02 / $1,171.92	Professional		$349.87	$600.02	$1,171.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $410.41 / $422.78 / $636.71	Professional		$410.41	$422.78	$636.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,398.00 / $2,170.00	Facility		$937.00	$1,398.00	$2,170.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $376.93 / $550.10 / $998.98	Professional		$376.93	$550.10	$998.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $414.49 / $518.11 / $615.63	Facility		$414.49	$518.11	$615.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $583.65 / $689.77 / $1,252.03	Professional		$583.65	$689.77	$1,252.03
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 $389.62 / $636.20 / $942.62	Professional		$389.62	$636.20	$942.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $414.61 / $657.16 / $945.63	Professional		$414.61	$657.16	$945.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $482.84 / $665.34 / $893.02	Professional		$482.84	$665.34	$893.02
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 $413.94 / $615.98 / $975.86	Professional		$413.94	$615.98	$975.86