Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,292.00 / $7,636.04 / $17,196.45	Facility		$2,292.00	$7,636.04	$17,196.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,261.68 / $1,505.52 / $2,996.77	Professional		$1,261.68	$1,505.52	$2,996.77
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $193.49 / $321.69 / $585.39	Professional	AS	$193.49	$321.69	$585.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,298.97 / $1,496.45 / $1,728.46	Professional		$1,298.97	$1,496.45	$1,728.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,372.00 / $11,476.00 / $31,065.00	Facility		$4,372.00	$11,476.00	$31,065.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,227.74 / $1,699.85 / $2,681.90	Professional		$1,227.74	$1,699.85	$2,681.90
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $171.88 / $236.61 / $375.46	Professional	AS	$171.88	$236.61	$375.46
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,547.82 / $1,602.61 / $1,643.70	Professional		$1,547.82	$1,602.61	$1,643.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,369.75 / $1,643.70 / $2,054.63	Facility		$1,369.75	$1,643.70	$2,054.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,428.87 / $1,780.68 / $2,671.02	Professional		$1,428.87	$1,780.68	$2,671.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,427.83 / $1,986.14 / $2,855.64	Professional		$1,427.83	$1,986.14	$2,855.64
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,574.35 / $6,883.14 / $24,712.75	Facility		$3,574.35	$6,883.14	$24,712.75
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $161.91 / $161.91 / $161.91	Facility	AS	$161.91	$161.91	$161.91
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,438.24 / $2,013.53 / $2,922.75	Professional		$1,438.24	$2,013.53	$2,922.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.74 / $993.60 / $1,682.78	Professional		$144.74	$993.60	$1,682.78
United Facility/Professional Facility Modifier Low / Median / High Price $4,873.00 / $10,707.00 / $15,869.00	Facility		$4,873.00	$10,707.00	$15,869.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,144.64 / $1,781.72 / $2,937.42	Professional		$1,144.64	$1,781.72	$2,937.42