Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $2,570.40 / $7,079.46	Facility		$323.59	$2,570.40	$7,079.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $724.44	Professional		$199.53	$309.03	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $208.93 / $309.03	Professional		$181.97	$208.93	$309.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,238.72 / $3,981.07	Facility		$707.95	$2,238.72	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $478.63	Professional		$190.55	$263.03	$478.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $229.09 / $251.19	Facility		$169.82	$229.09	$251.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $524.81	Professional		$245.47	$323.59	$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 $190.55 / $288.40 / $446.68	Professional		$190.55	$288.40	$446.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,511.89 / $4,786.30	Facility		$1,230.27	$2,511.89	$4,786.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $467.74	Professional		$194.98	$288.40	$467.74
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 / $1,949.84	Facility		$100.00	$100.00	$1,949.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $263.03 / $489.78	Professional		$186.21	$263.03	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $5,248.07	Facility		$1,698.24	$2,570.40	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $407.38	Professional		$199.53	$281.84	$407.38