Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.11 / $1,902.00 / $9,534.00	Facility		$122.11	$1,902.00	$9,534.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.14 / $179.27 / $312.27	Professional		$68.14	$179.27	$312.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.63 / $162.63 / $192.68	Professional		$162.63	$162.63	$192.68
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 $67.95 / $193.35 / $312.26	Professional		$67.95	$193.35	$312.26
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $101.92 / $290.02 / $468.39	Professional	50	$101.92	$290.02	$468.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.17 / $101.97 / $167.04	Facility		$83.17	$101.97	$167.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $204.11 / $318.42	Professional		$70.70	$204.11	$318.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.37 / $123.06 / $21,571.00	Facility		$115.37	$123.06	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.18 / $172.58 / $331.42	Professional		$67.18	$172.58	$331.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $123.06 / $137.22 / $446.92	Facility		$123.06	$137.22	$446.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $179.62 / $331.42	Professional		$73.00	$179.62	$331.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $136.01 / $185.41 / $254.04	Professional		$136.01	$185.41	$254.04
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 $155.43 / $203.65 / $379.21	Professional		$155.43	$203.65	$379.21