Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $6,165.95 / $11,481.54	Facility		$1,659.59	$6,165.95	$11,481.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,659.59 / $3,801.89	Professional		$954.99	$1,659.59	$3,801.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $954.99 / $1,698.24	Professional		$138.04	$954.99	$1,698.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $7,244.36 / $22,908.68	Facility		$3,090.30	$7,244.36	$22,908.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $1,995.26	Professional		$912.01	$1,230.27	$1,995.26
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,148.15 / $1,905.46	Professional		$1,096.48	$1,148.15	$1,905.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,318.26 / $1,737.80	Facility		$1,023.29	$1,318.26	$1,737.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,348.96 / $2,454.71	Professional		$1,047.13	$1,348.96	$2,454.71
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 $1,023.29 / $1,445.44 / $2,089.30	Professional		$1,023.29	$1,445.44	$2,089.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $4,265.80 / $7,079.46	Facility		$1,737.80	$4,265.80	$7,079.46
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,412.54 / $2,041.74	Professional		$912.01	$1,412.54	$2,041.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $190.55	Professional		$32.36	$33.11	$190.55
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,089.30 / $8,912.51	Facility		$100.00	$2,089.30	$8,912.51
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,230.27 / $2,041.74	Professional		$1,000.00	$1,230.27	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $9,549.93 / $14,791.08	Facility		$4,265.80	$9,549.93	$14,791.08
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,230.27 / $1,905.46	Professional		$812.83	$1,230.27	$1,905.46