Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,308.36 / $5,616.00 / $10,635.00	Facility		$1,308.36	$5,616.00	$10,635.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,051.57 / $1,232.82 / $2,854.63	Professional		$1,051.57	$1,232.82	$2,854.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,513.73 / $1,513.73 / $1,513.73	Professional		$1,513.73	$1,513.73	$1,513.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,134.00 / $10,048.00 / $36,529.00	Facility		$2,134.00	$10,048.00	$36,529.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $927.77 / $1,294.73 / $2,053.42	Professional		$927.77	$1,294.73	$2,053.42
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,397.29 / $1,397.29 / $1,397.29	Professional		$1,397.29	$1,397.29	$1,397.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,088.73 / $1,397.29 / $1,855.79	Facility		$1,088.73	$1,397.29	$1,855.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,280.84 / $1,630.17 / $127,498.73	Professional		$1,280.84	$1,630.17	$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 $1,205.33 / $1,630.18 / $2,364.05	Professional		$1,205.33	$1,630.18	$2,364.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,388.99 / $1,388.99 / $1,388.99	Facility		$1,388.99	$1,388.99	$1,388.99
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,222.63 / $1,680.85 / $2,364.05	Professional		$1,222.63	$1,680.85	$2,364.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.74 / $839.67 / $1,453.94	Professional		$144.74	$839.67	$1,453.94
United Facility/Professional Facility Modifier Low / Median / High Price $4,070.00 / $8,448.00 / $13,382.00	Facility		$4,070.00	$8,448.00	$13,382.00
United Facility/Professional Professional Modifier Low / Median / High Price $984.65 / $1,508.44 / $2,349.21	Professional		$984.65	$1,508.44	$2,349.21