Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.36 / $3,707.00 / $11,581.00	Facility		$494.36	$3,707.00	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.70 / $1,024.10 / $2,263.80	Professional		$304.70	$1,024.10	$2,263.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $850.76 / $1,020.92 / $1,020.92	Professional		$850.76	$1,020.92	$1,020.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,009.00 / $3,683.00 / $15,092.00	Facility		$2,009.00	$3,683.00	$15,092.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $294.58 / $914.29 / $2,692.81	Professional		$294.58	$914.29	$2,692.81
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $441.87 / $1,371.44 / $3,981.70	Professional	50	$441.87	$1,371.44	$3,981.70
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $961.36 / $961.36 / $961.36	Professional		$961.36	$961.36	$961.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $265.74 / $386.95 / $488.49	Facility		$265.74	$386.95	$488.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $935.84 / $1,493.21 / $1,658.99	Professional		$935.84	$1,493.21	$1,658.99
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 $296.64 / $935.84 / $2,184.75	Professional		$296.64	$935.84	$2,184.75
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,782.55 / $6,867.11 / $9,170.04	Facility		$2,782.55	$6,867.11	$9,170.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $312.63 / $972.16 / $2,375.54	Professional		$312.63	$972.16	$2,375.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $788.61 / $1,041.92 / $1,416.42	Professional		$788.61	$1,041.92	$1,416.42
United Facility/Professional Facility Modifier Low / Median / High Price $2,326.58 / $4,956.00 / $7,778.00	Facility		$2,326.58	$4,956.00	$7,778.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,037.47 / $1,452.30 / $2,290.77	Professional		$1,037.47	$1,452.30	$2,290.77