Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $7,079.46 / $12,022.64	Facility		$1,513.56	$7,079.46	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,047.13 / $3,715.35	Professional		$912.01	$1,047.13	$3,715.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $5,754.40 / $30,199.52	Facility		$2,137.96	$5,754.40	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,318.26 / $2,089.30	Professional		$977.24	$1,318.26	$2,089.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,148.15	Facility		$977.24	$977.24	$1,148.15
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 $954.99 / $1,380.38 / $2,089.30	Professional		$954.99	$1,380.38	$2,089.30
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 $870.96 / $1,380.38 / $2,089.30	Professional		$870.96	$1,380.38	$2,089.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $15,848.93	Facility		$100.00	$100.00	$15,848.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,096.48 / $2,089.30	Professional		$933.25	$1,096.48	$2,089.30
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,918.31 / $11,220.18	Facility		$3,890.45	$6,918.31	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,174.90 / $1,778.28	Professional		$776.25	$1,174.90	$1,778.28