Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $2,041.74 / $10,715.19	Facility		$109.65	$2,041.74	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $131.83 / $331.13	Professional		$75.86	$131.83	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $147.91	Professional		$123.03	$123.03	$147.91
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 $75.86 / $102.33 / $158.49	Professional		$75.86	$102.33	$158.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $95.50 / $125.89	Facility		$74.13	$95.50	$125.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $165.96 / $288.40	Professional		$125.89	$165.96	$288.40
Cigna 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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $245.47	Professional		$89.13	$144.54	$245.47
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $1,348.96 / $21,379.62	Facility		$52.48	$1,348.96	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $245.47	Professional		$87.10	$141.25	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $77.62	Professional		$32.36	$33.11	$77.62
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,096.48	Facility		$100.00	$100.00	$1,096.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $144.54 / $218.78	Professional		$75.86	$144.54	$218.78
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 $74.13 / $131.83 / $234.42	Professional		$74.13	$131.83	$234.42