Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $7,585.78 / $12,022.64	Facility		$2,398.83	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,548.82 / $6,025.60	Professional		$1,288.25	$1,548.82	$6,025.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $16,982.44	Facility		$2,238.72	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,584.89 / $2,511.89	Professional		$1,202.26	$1,584.89	$2,511.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,584.89	Facility		$1,348.96	$1,348.96	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,238.72 / $21,379.62	Facility		$1,698.24	$2,238.72	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $2,818.38	Professional		$1,318.26	$1,862.09	$2,818.38
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 $1,230.27 / $1,905.46 / $3,019.95	Professional		$1,230.27	$1,905.46	$3,019.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $218.78	Professional		$32.36	$33.11	$218.78
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $7,244.36	Facility		$100.00	$100.00	$7,244.36
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,445.44 / $2,754.23	Professional		$1,230.27	$1,445.44	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,760.83 / $11,220.18	Facility		$3,890.45	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $2,570.40	Professional		$1,047.13	$1,621.81	$2,570.40