Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.41 / $2,292.00 / $9,504.00	Facility		$130.41	$2,292.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.01 / $127.91 / $225.04	Professional		$89.01	$127.91	$225.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.12 / $110.12 / $110.12	Professional		$110.12	$110.12	$110.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,412.00 / $8,800.00	Facility		$1,145.00	$2,412.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.41 / $132.06 / $252.10	Professional		$95.41	$132.06	$252.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $143.11 / $198.09 / $378.15	Professional	50	$143.11	$198.09	$378.15
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $124.44 / $124.44 / $124.44	Professional		$124.44	$124.44	$124.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $107.91 / $132.30 / $1,525.80	Facility		$107.91	$132.30	$1,525.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.73 / $137.65 / $214.74	Professional		$91.73	$137.65	$214.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.79 / $1,124.08 / $21,571.00	Facility		$149.79	$1,124.08	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.16 / $136.96 / $276.14	Professional		$87.16	$136.96	$276.14
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,124.08 / $1,253.49 / $2,416.59	Facility		$1,124.08	$1,253.49	$2,416.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $88.52 / $141.84 / $253.27	Professional		$88.52	$141.84	$253.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $151.78 / $205.16	Professional		$109.37	$151.78	$205.16
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 $106.44 / $143.44 / $266.08	Professional		$106.44	$143.44	$266.08