Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $5,248.07 / $10,000.00	Facility		$1,047.13	$5,248.07	$10,000.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Facility	22	$3,467.37	$3,467.37	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $891.25 / $2,884.03	Professional		$630.96	$891.25	$2,884.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $691.83 / $912.01	Professional		$549.54	$691.83	$912.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $3,019.95 / $7,943.28	Facility		$1,071.52	$3,019.95	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $645.65 / $1,096.48	Professional		$467.74	$645.65	$1,096.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $741.31 / $870.96	Facility		$616.60	$741.31	$870.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $831.76 / $1,445.44	Professional		$741.31	$831.76	$1,445.44
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 $331.13 / $831.76 / $1,258.93	Professional		$331.13	$831.76	$1,258.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $2,511.89 / $5,370.32	Facility		$1,096.48	$2,511.89	$5,370.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $812.83 / $1,258.93	Professional		$331.13	$812.83	$1,258.93
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 / $4,073.80	Facility		$100.00	$100.00	$4,073.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $794.33 / $1,348.96	Professional		$616.60	$794.33	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $4,365.16 / $7,413.10	Facility		$2,454.71	$4,365.16	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $691.83 / $1,230.27	Professional		$501.19	$691.83	$1,230.27