Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $2,089.30 / $10,715.19	Facility		$158.49	$2,089.30	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $245.47 / $457.09	Professional		$147.91	$245.47	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $389.05	Professional		$169.82	$239.88	$389.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,137.96 / $2,511.89	Facility		$1,318.26	$2,137.96	$2,511.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $380.19	Professional		$131.83	$199.53	$380.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $204.17 / $239.88	Facility		$169.82	$204.17	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $331.13 / $588.84	Professional		$295.12	$331.13	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $162.18 / $21,379.62	Facility		$144.54	$162.18	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $416.87	Professional		$162.18	$263.03	$416.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $21,379.62	Facility		$181.97	$181.97	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $263.03 / $416.87	Professional		$151.36	$263.03	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $263.03 / $407.38	Professional		$177.83	$263.03	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $2,951.21 / $6,760.83	Facility		$1,047.13	$2,951.21	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $346.74	Professional		$128.82	$190.55	$346.74