Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $2,818.38 / $10,715.19	Facility		$42.66	$2,818.38	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $141.25	Professional		$32.36	$51.29	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $41.69 / $45.71	Professional		$25.70	$41.69	$45.71
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 $33.11 / $43.65 / $79.43	Professional		$33.11	$43.65	$79.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $38.90 / $64.57	Facility		$33.11	$38.90	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $70.79 / $21,379.62	Facility		$44.67	$70.79	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $95.50	Professional		$36.31	$54.95	$95.50
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $776.25 / $21,379.62	Facility		$575.44	$776.25	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $93.33	Professional		$33.11	$53.70	$93.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $32.36 / $33.11	Professional		$17.78	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $380.19	Facility		$100.00	$100.00	$380.19
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $87.10	Professional		$30.20	$46.77	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $75.86	Professional		$29.51	$46.77	$75.86