Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $2,398.83 / $5,128.61	Facility		$239.88	$2,398.83	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $234.42 / $616.60	Professional		$102.33	$234.42	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $169.82 / $398.11	Professional		$91.20	$169.82	$398.11
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 $97.72 / $131.83 / $223.87	Professional		$97.72	$131.83	$223.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $128.82 / $173.78	Facility		$102.33	$128.82	$173.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $316.23 / $549.54	Professional		$239.88	$316.23	$549.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $436.52 / $21,379.62	Facility		$173.78	$436.52	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $213.80 / $426.58	Professional		$114.82	$213.80	$426.58
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,621.81 / $3,162.28	Facility		$1,096.48	$1,621.81	$3,162.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $416.87	Professional		$112.20	$204.17	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
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 $97.72 / $229.09 / $407.38	Professional		$97.72	$229.09	$407.38
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 $95.50 / $194.98 / $389.05	Professional		$95.50	$194.98	$389.05