Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.69 / $216.00 / $223.00	Facility		$130.69	$216.00	$223.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.12 / $112.32 / $130.69	Professional		$78.12	$112.32	$130.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.75 / $42.50 / $57.50	Professional		$32.75	$42.50	$57.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $0.03	Professional		$0.02	$0.02	$0.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $298.49 / $298.49 / $298.49	Facility		$298.49	$298.49	$298.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Professional		$2.00	$2.00	$2.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Professional		$2.00	$2.00	$2.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $50.00 / $60.00	Professional		$30.00	$50.00	$60.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $216.00 / $216.00 / $216.00	Professional		$216.00	$216.00	$216.00