Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $1,548.82 / $7,079.46	Facility		$102.33	$1,548.82	$7,079.46
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $204.17 / $691.83 / $2,187.76	Facility	52	$204.17	$691.83	$2,187.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $141.25 / $389.05	Professional		$61.66	$141.25	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $74.13 / $128.82	Professional		$57.54	$74.13	$128.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,995.26 / $3,981.07	Facility		$707.95	$1,995.26	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $87.10 / $151.36	Professional		$61.66	$87.10	$151.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $74.13 / $83.18	Facility		$61.66	$74.13	$83.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $208.93	Professional		$141.25	$181.97	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $173.78 / $21,379.62	Facility		$91.20	$173.78	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $239.88	Professional		$70.79	$134.90	$239.88
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,412.54 / $2,511.89	Facility		$1,000.00	$1,412.54	$2,511.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $125.89 / $239.88	Professional		$69.18	$125.89	$239.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $34.67	Professional		$31.62	$33.11	$34.67
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $870.96	Facility		$100.00	$100.00	$870.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $162.18 / $245.47	Professional		$60.26	$162.18	$245.47
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 $56.23 / $114.82 / $218.78	Professional		$56.23	$114.82	$218.78