Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.49 / $1,285.19 / $2,995.00	Facility		$164.49	$1,285.19	$2,995.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.26 / $194.24 / $337.07	Professional		$113.26	$194.24	$337.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.08 / $111.08 / $111.08	Professional		$111.08	$111.08	$111.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.80 / $182.06 / $406.35	Professional		$114.80	$182.06	$406.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.98 / $126.23 / $149.97	Facility		$100.98	$126.23	$149.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.49 / $183.76 / $322.43	Professional		$155.49	$183.76	$322.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.18 / $181.32 / $320.07	Professional		$121.18	$181.32	$320.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $740.76 / $1,249.47 / $2,980.70	Facility		$740.76	$1,249.47	$2,980.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $126.23 / $182.34 / $320.07	Professional		$126.23	$182.34	$320.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.59 / $152.37 / $205.16	Professional		$115.59	$152.37	$205.16
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $4,132.00	Facility		$1,020.00	$1,940.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $150.49 / $230.84 / $336.09	Professional		$150.49	$230.84	$336.09