Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $2,089.30 / $10,715.19	Facility		$309.03	$2,089.30	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $794.33	Professional		$245.47	$323.59	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $407.38	Professional		$181.97	$251.19	$407.38
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $302.00	Facility		$257.04	$257.04	$302.00
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 $251.19 / $354.81 / $524.81	Professional		$251.19	$354.81	$524.81
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 $239.88 / $354.81 / $524.81	Professional		$239.88	$354.81	$524.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $128.82	Professional		$32.36	$33.11	$128.82
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $302.00	Facility		$100.00	$100.00	$302.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $346.74 / $616.60	Professional		$269.15	$346.74	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $281.84 / $457.09	Professional		$190.55	$281.84	$457.09