Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $3,019.95 / $10,715.19	Facility		$269.15	$3,019.95	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $501.19 / $1,819.70	Professional		$144.54	$501.19	$1,819.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $245.47	Professional		$112.20	$151.36	$245.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,238.72 / $7,943.28	Facility		$1,000.00	$2,238.72	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $562.34 / $1,047.13	Professional		$147.91	$562.34	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $147.91 / $165.96	Facility		$138.04	$147.91	$165.96
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 $162.18 / $323.59 / $1,230.27	Professional		$162.18	$323.59	$1,230.27
Medical Mutual of Ohio 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
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $323.59 / $1,230.27	Professional		$162.18	$323.59	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,949.84	Facility		$100.00	$100.00	$1,949.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $630.96 / $1,380.38	Professional		$134.90	$630.96	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $4,073.80	Facility		$1,096.48	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $416.87 / $1,202.26	Professional		$151.36	$416.87	$1,202.26