Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.59 / $2,218.00 / $9,504.00	Facility		$217.59	$2,218.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.76 / $217.59 / $373.16	Professional		$103.76	$217.59	$373.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.30 / $110.30 / $110.30	Professional		$110.30	$110.30	$110.30
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 $102.68 / $137.94 / $250.84	Professional		$102.68	$137.94	$250.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.04 / $137.31 / $163.15	Facility		$112.04	$137.31	$163.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $248.56 / $248.56 / $282.45	Professional		$248.56	$248.56	$282.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.57 / $198.57 / $21,571.00	Facility		$198.57	$198.57	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.49 / $238.43 / $463.80	Professional		$131.49	$238.43	$463.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $198.57 / $198.57 / $280.70	Facility		$198.57	$198.57	$280.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $131.49 / $233.65 / $422.25	Professional		$131.49	$233.65	$422.25
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 $200.28 / $312.02 / $552.32	Professional		$200.28	$312.02	$552.32