Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.48 / $1,902.00 / $9,504.00	Facility		$178.48	$1,902.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.99 / $215.87 / $333.56	Professional		$104.99	$215.87	$333.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.44 / $111.44 / $111.90	Professional		$111.44	$111.44	$111.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,051.00 / $1,981.00 / $3,943.00	Facility		$1,051.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.31 / $140.34 / $254.48	Professional		$98.31	$140.34	$254.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $113.66 / $139.30 / $165.52	Facility		$113.66	$139.30	$165.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $250.29 / $250.29 / $284.43	Professional		$250.29	$250.29	$284.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $201.46 / $201.46 / $21,571.00	Facility		$201.46	$201.46	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.40 / $240.12 / $469.90	Professional		$133.40	$240.12	$469.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $201.46 / $201.46 / $284.38	Facility		$201.46	$201.46	$284.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $133.40 / $236.73 / $425.12	Professional		$133.40	$236.73	$425.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $193.10 / $255.58 / $357.59	Professional		$193.10	$255.58	$357.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $4,132.00	Facility		$1,020.00	$1,940.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $243.12 / $346.82 / $606.49	Professional		$243.12	$346.82	$606.49