Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,818.38 / $8,912.51	Facility		$426.58	$2,818.38	$8,912.51
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility	22	$2,630.27	$2,630.27	$2,630.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $467.74 / $1,047.13	Professional		$275.42	$467.74	$1,047.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $354.81 / $501.19	Professional		$257.04	$354.81	$501.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,818.38 / $7,943.28	Facility		$1,000.00	$2,818.38	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $616.60	Professional		$257.04	$371.54	$616.60
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $891.25	Professional		$467.74	$467.74	$891.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
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 $295.12 / $467.74 / $831.76	Professional		$295.12	$467.74	$831.76
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,691.53 / $14,791.08	Facility		$1,584.89	$2,691.53	$14,791.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $457.09 / $758.58	Professional		$288.40	$457.09	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
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 $281.84 / $457.09 / $831.76	Professional		$281.84	$457.09	$831.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $5,248.07	Facility		$1,698.24	$2,570.40	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $660.69	Professional		$263.03	$398.11	$660.69