Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $764.00 / $2,898.75 / $6,941.31	Facility		$764.00	$2,898.75	$6,941.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $283.62 / $538.61 / $995.00	Professional		$283.62	$538.61	$995.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $189.53 / $305.33 / $530.25	Professional		$189.53	$305.33	$530.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.20 / $306.54 / $557.15	Professional		$207.20	$306.54	$557.15
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $307.43 / $335.38 / $636.29	Professional		$307.43	$335.38	$636.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $279.48 / $335.38 / $419.22	Facility		$279.48	$335.38	$419.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $550.79 / $689.33 / $873.28	Professional		$550.79	$689.33	$873.28
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 $319.00 / $529.71 / $964.33	Professional		$319.00	$529.71	$964.33
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $552.54 / $1,596.49 / $3,164.61	Facility		$552.54	$1,596.49	$3,164.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $286.66 / $503.06 / $942.31	Professional		$286.66	$503.06	$942.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $376.73 / $678.75	Professional		$34.85	$376.73	$678.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,600.00 / $5,235.00	Facility		$1,689.00	$2,600.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $447.46 / $682.33 / $1,082.08	Professional		$447.46	$682.33	$1,082.08