Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $3,467.37 / $9,549.93	Facility		$489.78	$3,467.37	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $549.54 / $1,698.24	Professional		$263.03	$549.54	$1,698.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $426.58	Professional		$213.80	$257.04	$426.58
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 $275.42 / $707.95 / $1,288.25	Professional		$275.42	$707.95	$1,288.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $316.23 / $338.84	Facility		$229.09	$316.23	$338.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,096.48 / $1,862.09	Professional		$851.14	$1,096.48	$1,862.09
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 $269.15 / $537.03 / $1,258.93	Professional		$269.15	$537.03	$1,258.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $6,606.93 / $21,379.62	Facility		$6,606.93	$6,606.93	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $602.56 / $1,348.96	Professional		$275.42	$602.56	$1,348.96
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 / $3,890.45	Facility		$100.00	$100.00	$3,890.45
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $776.25 / $1,445.44	Professional		$251.19	$776.25	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,754.40 / $8,511.38	Facility		$2,818.38	$5,754.40	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $707.95 / $1,348.96	Professional		$281.84	$707.95	$1,348.96