Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.79 / $2,785.00 / $9,516.00	Facility		$190.79	$2,785.00	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.66 / $235.98 / $411.68	Professional		$107.66	$235.98	$411.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.60 / $115.06 / $160.44	Professional		$114.60	$115.06	$160.44
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 $107.12 / $154.51 / $266.07	Professional		$107.12	$154.51	$266.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $116.89 / $143.25 / $170.21	Facility		$116.89	$143.25	$170.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $270.95 / $270.95 / $307.89	Professional		$270.95	$270.95	$307.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $207.15 / $207.15 / $21,571.00	Facility		$207.15	$207.15	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.81 / $258.64 / $505.00	Professional		$136.81	$258.64	$505.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $207.15 / $304.74 / $4,132.00	Facility		$207.15	$304.74	$4,132.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $136.81 / $249.85 / $458.38	Professional		$136.81	$249.85	$458.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $219.95 / $291.90 / $407.76	Professional		$219.95	$291.90	$407.76
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 $252.36 / $367.36 / $618.87	Professional		$252.36	$367.36	$618.87