Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,128.61 / $10,964.78	Facility		$1,698.24	$5,128.61	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,479.11 / $4,677.35	Professional		$1,071.52	$1,479.11	$4,677.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $1,202.26	Professional		$602.56	$602.56	$1,202.26
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 $1,148.15 / $1,445.44 / $2,398.83	Professional		$1,148.15	$1,445.44	$2,398.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
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 $1,122.02 / $1,659.59 / $2,511.89	Professional		$1,122.02	$1,659.59	$2,511.89
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 $1,122.02 / $1,698.24 / $2,511.89	Professional		$1,122.02	$1,698.24	$2,511.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $812.83	Professional		$32.36	$33.11	$812.83
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 $1,174.90 / $1,380.38 / $2,238.72	Professional		$1,174.90	$1,380.38	$2,238.72
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 $1,047.13 / $1,380.38 / $2,238.72	Professional		$1,047.13	$1,380.38	$2,238.72