Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $9,120.11 / $12,302.69	Facility		$4,168.69	$9,120.11	$12,302.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,258.93 / $9,120.11	Professional		$776.25	$1,258.93	$9,120.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $4,168.69 / $15,135.61	Facility		$1,949.84	$4,168.69	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,244.36 / $9,549.93 / $15,488.17	Professional		$7,244.36	$9,549.93	$15,488.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $20,417.38 / $45,708.82	Facility		$1,318.26	$20,417.38	$45,708.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $22,387.21 / $39,810.72	Professional		$1,737.80	$22,387.21	$39,810.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $60.26	Professional		$32.36	$50.12	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $6,918.31 / $6,918.31	Facility		$6,918.31	$6,918.31	$6,918.31
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $75.86	Professional		$60.26	$60.26	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,754.40 / $9,120.11	Facility		$2,951.21	$5,754.40	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,659.59 / $2,511.89	Professional		$1,096.48	$1,659.59	$2,511.89