Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,021.25 / $3,999.00 / $9,863.00	Facility		$1,021.25	$3,999.00	$9,863.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $752.19 / $1,016.63 / $1,765.49	Professional		$752.19	$1,016.63	$1,765.49
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $727.08 / $727.08 / $920.60	Professional	AS	$727.08	$727.08	$920.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $916.07 / $916.07 / $978.94	Professional		$916.07	$916.07	$978.94
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $86.78 / $86.78 / $86.78	Professional	AS	$86.78	$86.78	$86.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,528.00 / $14,996.00	Facility		$1,760.00	$3,528.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $745.95 / $1,069.86 / $1,819.90	Professional		$745.95	$1,069.86	$1,819.90
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $104.43 / $149.78 / $254.78	Professional	AS	$104.43	$149.78	$254.78
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,137.54 / $1,137.54 / $1,137.54	Professional		$1,137.54	$1,137.54	$1,137.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $818.07 / $1,022.59 / $1,206.33	Facility		$818.07	$1,022.59	$1,206.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,025.35 / $1,359.00 / $1,657.90	Professional		$1,025.35	$1,359.00	$1,657.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $768.84 / $1,157.67 / $1,881.57	Professional		$768.84	$1,157.67	$1,881.57
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,719.70 / $3,464.44 / $22,317.45	Facility		$1,719.70	$3,464.44	$22,317.45
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $839.10 / $1,236.15 / $1,881.57	Professional		$839.10	$1,236.15	$1,881.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $111.35 / $778.20 / $1,340.48	Professional		$111.35	$778.20	$1,340.48
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,625.00 / $7,853.00	Facility		$2,840.00	$5,625.00	$7,853.00
United Facility/Professional Professional Modifier Low / Median / High Price $881.49 / $1,144.13 / $1,860.60	Professional		$881.49	$1,144.13	$1,860.60