Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $3,630.78 / $10,964.78	Facility		$870.96	$3,630.78	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $288.40 / $2,511.89	Professional		$229.09	$288.40	$2,511.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $269.15	Professional		$112.20	$141.25	$269.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,548.13 / $15,135.61	Facility		$1,698.24	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $295.12 / $512.86	Professional		$229.09	$295.12	$512.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $245.47 / $281.84	Facility		$234.42	$245.47	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $302.00 / $21,379.62	Facility		$208.93	$302.00	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $354.81 / $501.19	Professional		$251.19	$354.81	$501.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,905.46 / $21,379.62	Facility		$1,023.29	$1,905.46	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $354.81 / $524.81	Professional		$251.19	$354.81	$524.81
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 / $4,570.88	Facility		$100.00	$100.00	$4,570.88
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $257.04 / $478.63	Professional		$218.78	$257.04	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,365.16 / $7,413.10	Facility		$2,570.40	$4,365.16	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $467.74	Professional		$213.80	$281.84	$467.74