Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $3,019.95 / $10,715.19	Facility		$870.96	$3,019.95	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $870.96 / $1,862.09	Professional		$602.56	$870.96	$1,862.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $660.69 / $1,148.15	Professional		$323.59	$660.69	$1,148.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,548.13 / $15,135.61	Facility		$1,698.24	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $891.25 / $1,445.44	Professional		$676.08	$891.25	$1,445.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
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 $645.65 / $977.24 / $1,548.82	Professional		$645.65	$977.24	$1,548.82
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
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $977.24 / $1,479.11	Professional		$630.96	$977.24	$1,479.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $457.09	Professional		$32.36	$33.11	$457.09
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $4,365.16	Facility		$100.00	$100.00	$4,365.16
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $912.01 / $1,659.59	Professional		$630.96	$912.01	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,754.40 / $8,511.38	Facility		$2,818.38	$5,754.40	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $831.76 / $1,348.96	Professional		$602.56	$831.76	$1,348.96