Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $2,818.38 / $10,715.19	Facility		$416.87	$2,818.38	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $2,344.23 / $5,248.07	Professional		$208.93	$2,344.23	$5,248.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $398.11	Professional		$213.80	$213.80	$398.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $407.38	Professional		$199.53	$257.04	$407.38
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $245.47	Facility		$208.93	$208.93	$245.47
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 $239.88 / $478.63 / $6,025.60	Professional		$239.88	$478.63	$6,025.60
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 $234.42 / $478.63 / $5,754.40	Professional		$234.42	$478.63	$5,754.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $169.82	Professional		$32.36	$33.11	$169.82
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $2,344.23 / $5,754.40	Professional		$194.98	$2,344.23	$5,754.40
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $2,290.87 / $5,888.44	Professional		$194.98	$2,290.87	$5,888.44