Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $2,630.27 / $10,715.19	Facility		$144.54	$2,630.27	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $144.54 / $478.63	Professional		$60.26	$144.54	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $120.23	Professional		$117.49	$117.49	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $154.88 / $288.40	Professional		$72.44	$154.88	$288.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $131.83 / $269.15	Professional		$56.23	$131.83	$269.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $131.83 / $257.04	Professional		$56.23	$131.83	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $134.90 / $257.04	Professional		$41.69	$134.90	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $478.63	Facility		$398.11	$398.11	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $117.49 / $234.42	Professional		$54.95	$117.49	$234.42