Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $39.81 / $549.54	Facility		$28.18	$39.81	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $32.36 / $52.48	Professional		$30.20	$32.36	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $28.84 / $28.84	Professional		$15.85	$28.84	$28.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $56.23 / $154.88	Facility		$32.36	$56.23	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $34.67 / $56.23	Professional		$30.90	$34.67	$56.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Facility		$45.71	$45.71	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Facility		$33.88	$33.88	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $52.48	Professional		$33.88	$33.88	$52.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Facility		$33.88	$33.88	$33.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $52.48	Professional		$33.88	$33.88	$52.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $48.98	Professional		$33.88	$42.66	$48.98
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $776,247.12 / $776,247.12 / $776,247.12	Facility		$776,247.12	$776,247.12	$776,247.12
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $36.31 / $74.13	Professional		$33.88	$36.31	$74.13
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $32.36	Facility		$30.90	$30.90	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $36.31 / $41.69	Professional		$33.11	$36.31	$41.69