Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $9,332.54 / $12,302.69	Facility		$4,168.69	$9,332.54	$12,302.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,445.44 / $10,232.93	Professional		$912.01	$1,445.44	$10,232.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Professional		$2,951.21	$2,951.21	$2,951.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $5,888.44 / $15,135.61	Facility		$1,949.84	$5,888.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,380.38 / $2,187.76	Professional		$1,122.02	$1,380.38	$2,187.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $25,703.96 / $41,686.94	Facility		$1,698.24	$25,703.96	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $29,512.09 / $51,286.14	Professional		$2,290.87	$29,512.09	$51,286.14
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 $30.20 / $60.26 / $60.26	Professional		$30.20	$60.26	$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 $4,265.80 / $9,332.54 / $13,803.84	Facility		$4,265.80	$9,332.54	$13,803.84
United Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,778.28 / $2,754.23	Professional		$1,318.26	$1,778.28	$2,754.23