Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $2,511.89 / $9,120.11	Facility		$977.24	$2,511.89	$9,120.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,148.15 / $2,818.38	Professional		$758.58	$1,148.15	$2,818.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,412.54 / $1,778.28	Professional		$707.95	$1,412.54	$1,778.28
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 $724.44 / $933.25 / $1,548.82	Professional		$724.44	$933.25	$1,548.82
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
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 $794.33 / $1,122.02 / $1,905.46	Professional		$794.33	$1,122.02	$1,905.46
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $21,379.62	Facility		$2,041.74	$2,041.74	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,174.90 / $1,737.80	Professional		$776.25	$1,174.90	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $512.86	Professional		$32.36	$33.11	$512.86
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $2,511.89	Facility		$100.00	$100.00	$2,511.89
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,047.13 / $1,905.46	Professional		$741.31	$1,047.13	$1,905.46
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 $691.83 / $977.24 / $1,584.89	Professional		$691.83	$977.24	$1,584.89