Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $2,630.27 / $10,715.19	Facility		$158.49	$2,630.27	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $302.00	Professional		$91.20	$151.36	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $190.55	Professional		$89.13	$117.49	$190.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $112.20	Facility		$95.50	$95.50	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $269.15 / $21,379.62	Facility		$158.49	$269.15	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $288.40	Professional		$107.15	$169.82	$288.40
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 $107.15 / $165.96 / $275.42	Professional		$107.15	$165.96	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
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 $91.20 / $162.18 / $251.19	Professional		$91.20	$162.18	$251.19
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 $87.10 / $147.91 / $257.04	Professional		$87.10	$147.91	$257.04