Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $3,019.95 / $10,715.19	Facility		$478.63	$3,019.95	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $1,096.48	Professional		$363.08	$436.52	$1,096.48
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 $1,000.00 / $2,187.76 / $7,943.28	Facility		$1,000.00	$2,187.76	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $630.96	Professional		$288.40	$398.11	$630.96
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $457.09	Facility		$389.05	$389.05	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $616.60 / $21,379.62	Facility		$398.11	$616.60	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $537.03 / $794.33	Professional		$380.19	$537.03	$794.33
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 $380.19 / $537.03 / $794.33	Professional		$380.19	$537.03	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $186.21	Professional		$32.36	$33.11	$186.21
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,995.26	Facility		$100.00	$100.00	$1,995.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $512.86 / $912.01	Professional		$398.11	$512.86	$912.01
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $1,023.29 / $3,235.94	Facility		$478.63	$1,023.29	$3,235.94
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $436.52 / $707.95	Professional		$288.40	$436.52	$707.95