Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.24 / $776.48 / $11,581.00	Facility		$133.24	$776.48	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.43 / $133.24 / $231.68	Professional		$112.43	$133.24	$231.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.07 / $111.07 / $111.07	Professional		$111.07	$111.07	$111.07
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 $88.42 / $116.82 / $226.24	Professional		$88.42	$116.82	$226.24
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $132.63 / $175.23 / $339.36	Professional	50	$132.63	$175.23	$339.36
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $138.72 / $138.72 / $138.72	Professional		$138.72	$138.72	$138.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.98 / $179.21 / $219.26	Facility		$99.98	$179.21	$219.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.38 / $153.44 / $239.39	Professional		$97.38	$153.44	$239.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.66 / $82.14 / $21,571.00	Facility		$73.66	$82.14	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.47 / $161.63 / $299.56	Professional		$111.47	$161.63	$299.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $73.66 / $82.14 / $458.83	Facility		$73.66	$82.14	$458.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $112.25 / $162.53 / $257.75	Professional		$112.25	$162.53	$257.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.48 / $112.43 / $154.20	Professional		$82.48	$112.43	$154.20
United Facility/Professional Facility Modifier Low / Median / High Price $309.00 / $975.00 / $3,218.00	Facility		$309.00	$975.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $110.65 / $140.13 / $282.76	Professional		$110.65	$140.13	$282.76