Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $2,089.30 / $9,549.93	Facility		$229.09	$2,089.30	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $245.47 / $575.44	Professional		$154.88	$245.47	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $213.80	Professional		$89.13	$120.23	$213.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $7,943.28	Facility		$1,000.00	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $346.74	Professional		$154.88	$208.93	$346.74
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $416.87	Professional		$169.82	$257.04	$416.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $21,379.62	Facility		$1,778.28	$1,778.28	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $251.19 / $398.11	Professional		$158.49	$251.19	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $120.23	Professional		$32.36	$33.11	$120.23
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $2,041.74	Facility		$100.00	$100.00	$2,041.74
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $239.88 / $436.52	Professional		$162.18	$239.88	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $4,073.80	Facility		$1,096.48	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $213.80 / $346.74	Professional		$147.91	$213.80	$346.74