Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $2,754.23 / $8,709.64	Facility		$389.05	$2,754.23	$8,709.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $331.13 / $812.83	Professional		$89.13	$331.13	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $288.40	Professional		$89.13	$100.00	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,388.44 / $15,135.61	Facility		$1,698.24	$3,388.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $354.81 / $602.56	Professional		$186.21	$354.81	$602.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $186.21 / $223.87	Facility		$162.18	$186.21	$223.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $457.09 / $524.81	Professional		$398.11	$457.09	$524.81
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 $194.98 / $346.74 / $588.84	Professional		$194.98	$346.74	$588.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,659.59 / $6,606.93	Facility		$870.96	$1,659.59	$6,606.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $346.74 / $616.60	Professional		$186.21	$346.74	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $83.18	Professional		$32.36	$33.11	$83.18
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 $169.82 / $407.38 / $741.31	Professional		$169.82	$407.38	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,691.53 / $5,248.07	Facility		$1,778.28	$2,691.53	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $316.23 / $602.56	Professional		$173.78	$316.23	$602.56