Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.57 / $1,967.00 / $8,553.00	Facility		$158.57	$1,967.00	$8,553.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.83 / $134.88 / $255.87	Professional		$95.83	$134.88	$255.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.91 / $142.06 / $199.81	Professional		$131.91	$142.06	$199.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,927.00 / $3,943.00	Facility		$814.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $116.11 / $188.10	Professional		$88.43	$116.11	$188.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $94.88 / $120.49 / $150.71	Facility		$94.88	$120.49	$150.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.16 / $156.99 / $199.81	Professional		$155.16	$156.99	$199.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.50 / $172.14 / $265.74	Professional		$117.50	$172.14	$265.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $181.52 / $684.96 / $1,817.44	Facility		$181.52	$684.96	$1,817.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $118.72 / $175.55 / $267.83	Professional		$118.72	$175.55	$267.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.45 / $176.62 / $252.60	Professional		$131.45	$176.62	$252.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $4,067.00	Facility		$1,020.00	$1,940.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $116.44 / $187.64 / $268.33	Professional		$116.44	$187.64	$268.33