Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.85 / $1,883.00 / $9,516.00	Facility		$144.85	$1,883.00	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.85 / $230.57 / $413.01	Professional		$144.85	$230.57	$413.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.02 / $174.02 / $271.23	Professional		$174.02	$174.02	$271.23
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 $123.77 / $190.02 / $377.10	Professional		$123.77	$190.02	$377.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $170.61 / $213.26 / $253.40	Facility		$170.61	$213.26	$253.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $270.01 / $319.10 / $574.41	Professional		$270.01	$319.10	$574.41
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 $145.76 / $260.88 / $413.30	Professional		$145.76	$260.88	$413.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $108.25 / $108.25 / $171.23	Facility		$108.25	$108.25	$171.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $176.58 / $270.00 / $413.30	Professional		$176.58	$270.00	$413.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $232.18 / $314.07 / $425.75	Professional		$232.18	$314.07	$425.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,771.00 / $3,098.00 / $6,792.00	Facility		$1,771.00	$3,098.00	$6,792.00
United Facility/Professional Professional Modifier Low / Median / High Price $142.56 / $237.88 / $431.58	Professional		$142.56	$237.88	$431.58