Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $6,025.60 / $11,748.98	Facility		$1,148.15	$6,025.60	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $2,884.03	Professional		$630.96	$851.14	$2,884.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $1,621.81	Professional		$616.60	$616.60	$1,621.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,715.35 / $15,135.61	Facility		$1,698.24	$3,715.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $724.44 / $1,202.26	Professional		$549.54	$724.44	$1,202.26
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
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 $616.60 / $870.96 / $1,258.93	Professional		$616.60	$870.96	$1,258.93
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 $645.65 / $891.25 / $1,412.54	Professional		$645.65	$891.25	$1,412.54
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 $616.60 / $776.25 / $1,445.44	Professional		$616.60	$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 $616.60 / $812.83 / $1,258.93	Professional		$616.60	$812.83	$1,258.93