Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $5,888.44 / $10,964.78	Facility		$1,202.26	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $831.76 / $3,235.94	Professional		$724.44	$831.76	$3,235.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,388.44 / $15,135.61	Facility		$1,698.24	$3,388.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $630.96 / $1,071.52	Professional		$467.74	$630.96	$1,071.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $912.01	Facility		$776.25	$776.25	$912.01
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 $691.83 / $1,023.29 / $1,548.82	Professional		$691.83	$1,023.29	$1,548.82
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 $691.83 / $1,023.29 / $1,621.81	Professional		$691.83	$1,023.29	$1,621.81
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 / $3,981.07	Facility		$100.00	$100.00	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $891.25 / $1,659.59	Professional		$758.58	$891.25	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,691.53 / $5,248.07	Facility		$1,778.28	$2,691.53	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $831.76 / $1,412.54	Professional		$537.03	$831.76	$1,412.54