Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,027.64 / $4,312.34 / $11,627.00	Facility		$1,027.64	$4,312.34	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.97 / $837.89 / $1,653.48	Professional		$549.97	$837.89	$1,653.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $568.20 / $568.20 / $568.20	Professional		$568.20	$568.20	$568.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,670.00 / $5,770.00 / $30,285.00	Facility		$2,670.00	$5,770.00	$30,285.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.21 / $491.27 / $886.39	Professional		$336.21	$491.27	$886.39
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $681.84 / $681.84 / $681.84	Professional		$681.84	$681.84	$681.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $531.27 / $681.84 / $905.57	Facility		$531.27	$681.84	$905.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,012.37 / $1,288.48 / $127,498.73	Professional		$1,012.37	$1,288.48	$127,498.73
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 $653.42 / $1,012.37 / $1,584.74	Professional		$653.42	$1,012.37	$1,584.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,021.88 / $9,654.85 / $13,533.55	Facility		$1,021.88	$9,654.85	$13,533.55
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $102.19 / $102.19 / $102.19	Facility	AS	$102.19	$102.19	$102.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $655.68 / $1,033.68 / $1,612.63	Professional		$655.68	$1,033.68	$1,612.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.98 / $684.85 / $1,171.21	Professional		$107.98	$684.85	$1,171.21
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,625.00 / $7,847.00	Facility		$2,840.00	$5,625.00	$7,847.00
United Facility/Professional Professional Modifier Low / Median / High Price $764.95 / $1,168.06 / $2,059.09	Professional		$764.95	$1,168.06	$2,059.09