Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $4,265.80 / $10,000.00	Facility		$691.83	$4,265.80	$10,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $426.58 / $1,862.09	Professional		$158.49	$426.58	$1,862.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $295.12 / $575.44	Professional		$131.83	$295.12	$575.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $7,943.28	Facility		$1,000.00	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $660.69 / $1,445.44	Professional		$194.98	$660.69	$1,445.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $177.83 / $199.53	Facility		$169.82	$177.83	$199.53
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 $181.97 / $562.34 / $1,445.44	Professional		$181.97	$562.34	$1,445.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,398.83 / $4,786.30	Facility		$1,548.82	$2,398.83	$4,786.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $524.81 / $1,445.44	Professional		$186.21	$524.81	$1,445.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
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 $158.49 / $707.95 / $1,479.11	Professional		$158.49	$707.95	$1,479.11
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 $177.83 / $616.60 / $1,479.11	Professional		$177.83	$616.60	$1,479.11