Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.31 / $2,785.00 / $9,504.00	Facility		$208.31	$2,785.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.18 / $1,331.35 / $2,444.92	Professional		$117.18	$1,331.35	$2,444.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,086.63 / $1,179.56 / $1,496.59	Professional		$1,086.63	$1,179.56	$1,496.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,786.00 / $8,800.00	Facility		$1,145.00	$2,786.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.14 / $997.52 / $2,064.61	Professional		$114.14	$997.52	$2,064.61
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $171.21 / $1,496.28 / $3,096.91	Professional	50	$171.21	$1,496.28	$3,096.91
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,227.89 / $1,227.89 / $1,227.89	Professional		$1,227.89	$1,227.89	$1,227.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $115.27 / $167.85 / $180.11	Facility		$115.27	$167.85	$180.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,195.29 / $1,697.80 / $2,118.92	Professional		$1,195.29	$1,697.80	$2,118.92
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 $128.38 / $318.38 / $2,233.27	Professional		$128.38	$318.38	$2,233.27
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,145.97 / $1,145.97 / $4,128.58	Facility		$1,145.97	$1,145.97	$4,128.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $137.66 / $956.73 / $2,233.27	Professional		$137.66	$956.73	$2,233.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $997.26 / $1,316.51 / $1,836.75	Professional		$997.26	$1,316.51	$1,836.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,600.00 / $5,268.00	Facility		$1,689.00	$2,600.00	$5,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,441.62 / $1,887.52 / $2,680.22	Professional		$1,441.62	$1,887.52	$2,680.22