Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $5,888.44 / $10,964.78	Facility		$1,659.59	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,412.54 / $4,168.69	Professional		$1,202.26	$1,412.54	$4,168.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Professional		$2,570.40	$2,570.40	$2,570.40
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 $912.01 / $1,230.27 / $1,949.84	Professional		$912.01	$1,230.27	$1,949.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,621.81	Facility		$1,380.38	$1,380.38	$1,621.81
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 $1,230.27 / $1,778.28 / $2,691.53	Professional		$1,230.27	$1,778.28	$2,691.53
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 $1,148.15 / $1,778.28 / $2,754.23	Professional		$1,148.15	$1,778.28	$2,754.23
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 / $3,548.13	Facility		$100.00	$100.00	$3,548.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,548.82 / $2,951.21	Professional		$1,318.26	$1,548.82	$2,951.21
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 $933.25 / $1,380.38 / $2,398.83	Professional		$933.25	$1,380.38	$2,398.83