Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.63 / $404.00 / $11,581.00	Facility		$110.63	$404.00	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.54 / $114.26 / $195.28	Professional		$93.54	$114.26	$195.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.29 / $98.29 / $98.29	Professional		$98.29	$98.29	$98.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.97 / $110.46 / $207.05	Professional		$74.97	$110.46	$207.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $112.45 / $165.66 / $310.57	Professional	50	$112.45	$165.66	$310.57
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $119.86 / $119.86 / $119.86	Professional		$119.86	$119.86	$119.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $121.81 / $175.70 / $13,841.13	Facility		$121.81	$175.70	$13,841.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.54 / $132.59 / $206.84	Professional		$103.54	$132.59	$206.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.65 / $168.65 / $21,571.00	Facility		$168.65	$168.65	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.93 / $138.84 / $266.11	Professional		$93.93	$138.84	$266.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $705.59 / $705.59 / $705.59	Facility		$705.59	$705.59	$705.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $96.18 / $140.01 / $220.88	Professional		$96.18	$140.01	$220.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $112.03 / $153.71	Professional		$81.79	$112.03	$153.71
United Facility/Professional Facility Modifier Low / Median / High Price $226.00 / $881.00 / $2,833.00	Facility		$226.00	$881.00	$2,833.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.92 / $124.29 / $257.42	Professional		$98.92	$124.29	$257.42