Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.80 / $2,113.00 / $9,504.00	Facility		$154.80	$2,113.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $142.60 / $260.69	Professional		$104.10	$142.60	$260.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.97 / $121.97 / $121.97	Professional		$121.97	$121.97	$121.97
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 $95.65 / $125.45 / $201.47	Professional		$95.65	$125.45	$201.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.68 / $131.66 / $164.69	Facility		$103.68	$131.66	$164.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $166.38 / $166.38 / $211.75	Professional		$166.38	$166.38	$211.75
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 $127.51 / $185.75 / $278.58	Professional		$127.51	$185.75	$278.58
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $197.98 / $762.90 / $1,708.17	Facility		$197.98	$762.90	$1,708.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $128.56 / $186.31 / $286.08	Professional		$128.56	$186.31	$286.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $162.74 / $213.48 / $304.53	Professional		$162.74	$213.48	$304.53
United Facility/Professional Facility Modifier Low / Median / High Price $520.20 / $1,452.00 / $3,756.00	Facility		$520.20	$1,452.00	$3,756.00
United Facility/Professional Professional Modifier Low / Median / High Price $124.21 / $198.00 / $283.14	Professional		$124.21	$198.00	$283.14