Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.99 / $1,866.00 / $9,504.00	Facility		$155.99	$1,866.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.54 / $152.85 / $294.87	Professional		$103.54	$152.85	$294.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.93 / $214.58 / $255.84	Professional		$153.93	$214.58	$255.84
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 $96.52 / $126.27 / $208.83	Professional		$96.52	$126.27	$208.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.81 / $130.57 / $163.31	Facility		$102.81	$130.57	$163.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $176.79 / $181.57 / $231.08	Professional		$176.79	$181.57	$231.08
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 $128.15 / $196.42 / $306.41	Professional		$128.15	$196.42	$306.41
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $196.86 / $1,026.47 / $1,759.07	Facility		$196.86	$1,026.47	$1,759.07
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $130.85 / $198.07 / $310.91	Professional		$130.85	$198.07	$310.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.93 / $176.62 / $252.60	Professional		$132.93	$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 $141.13 / $219.34 / $342.60	Professional		$141.13	$219.34	$342.60