Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $2,238.72 / $10,715.19	Facility		$162.18	$2,238.72	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $162.18 / $389.05	Professional		$81.28	$162.18	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
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 $70.79 / $95.50 / $165.96	Professional		$70.79	$95.50	$165.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $107.15	Facility		$91.20	$91.20	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $204.17 / $21,379.62	Facility		$97.72	$204.17	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $169.82 / $302.00	Professional		$93.33	$169.82	$302.00
Medical Mutual of Ohio 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
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $162.18 / $302.00	Professional		$93.33	$162.18	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $52.48	Professional		$32.36	$33.11	$52.48
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 $87.10 / $204.17 / $323.59	Professional		$87.10	$204.17	$323.59
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 $74.13 / $147.91 / $281.84	Professional		$74.13	$147.91	$281.84