Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,165.00 / $6,345.00 / $11,627.00	Facility		$1,165.00	$6,345.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $652.86 / $753.12 / $1,633.12	Professional		$652.86	$753.12	$1,633.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $697.45 / $697.45 / $697.45	Professional		$697.45	$697.45	$697.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,777.00 / $6,565.00 / $30,285.00	Facility		$2,777.00	$6,565.00	$30,285.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $649.38 / $878.57 / $1,387.05	Professional		$649.38	$878.57	$1,387.05
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $880.98 / $880.98 / $880.98	Professional		$880.98	$880.98	$880.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $686.43 / $880.98 / $1,170.05	Facility		$686.43	$880.98	$1,170.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $807.57 / $1,027.81 / $127,498.73	Professional		$807.57	$1,027.81	$127,498.73
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 $770.86 / $1,048.21 / $1,510.21	Professional		$770.86	$1,048.21	$1,510.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $877.89 / $877.89 / $877.89	Facility		$877.89	$877.89	$877.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $770.86 / $1,064.52 / $1,512.98	Professional		$770.86	$1,064.52	$1,512.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.37 / $537.55 / $931.86	Professional		$72.37	$537.55	$931.86
United Facility/Professional Facility Modifier Low / Median / High Price $3,879.00 / $5,737.62 / $9,483.00	Facility		$3,879.00	$5,737.62	$9,483.00
United Facility/Professional Professional Modifier Low / Median / High Price $618.96 / $943.97 / $1,553.24	Professional		$618.96	$943.97	$1,553.24