Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $489.78 / $9,549.93	Facility		$281.84	$489.78	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $398.11 / $776.25	Professional		$269.15	$398.11	$776.25
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $295.12 / $398.11 / $724.44	Professional	54	$295.12	$398.11	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $323.59 / $457.09	Professional		$295.12	$323.59	$457.09
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	54	$338.84	$338.84	$338.84
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 $186.21 / $251.19 / $426.58	Professional		$186.21	$251.19	$426.58
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $575.44 / $575.44	Professional		$389.05	$575.44	$575.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $331.13	Facility		$281.84	$281.84	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $457.09 / $21,379.62	Facility		$263.03	$457.09	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $380.19 / $562.34	Professional		$275.42	$380.19	$562.34
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $371.54 / $691.83	Facility		$181.97	$371.54	$691.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $380.19 / $562.34	Professional		$263.03	$380.19	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $138.04	Professional		$32.36	$33.11	$138.04
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 $275.42 / $363.08 / $645.65	Professional		$275.42	$363.08	$645.65
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 $204.17 / $302.00 / $489.78	Professional		$204.17	$302.00	$489.78