Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.77 / $1,967.00 / $9,504.00	Facility		$168.77	$1,967.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.79 / $181.28 / $320.14	Professional		$115.79	$181.28	$320.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.18 / $281.18 / $281.18	Professional		$281.18	$281.18	$281.18
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 $64.36 / $114.00 / $218.41	Professional		$64.36	$114.00	$218.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.16 / $140.59 / $219.68	Facility		$117.16	$140.59	$219.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $184.95 / $184.95 / $327.87	Professional		$184.95	$184.95	$327.87
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 $122.71 / $208.50 / $346.79	Professional		$122.71	$208.50	$346.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $140.15 / $215.66 / $346.79	Professional		$140.15	$215.66	$346.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $128.17 / $193.79 / $288.46	Professional		$128.17	$193.79	$288.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,075.00 / $1,940.00 / $4,067.00	Facility		$1,075.00	$1,940.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $158.38 / $225.92 / $370.47	Professional		$158.38	$225.92	$370.47