Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $8,912.51 / $12,302.69	Facility		$741.31	$8,912.51	$12,302.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $1,513.56 / $4,677.35	Professional		$426.58	$1,513.56	$4,677.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $363.08 / $645.65	Professional		$346.74	$363.08	$645.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $4,677.35 / $15,135.61	Facility		$1,949.84	$4,677.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $1,445.44 / $3,890.45	Professional		$407.38	$1,445.44	$3,890.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
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 $407.38 / $794.33 / $3,235.94	Professional		$407.38	$794.33	$3,235.94
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 $416.87 / $1,122.02 / $3,311.31	Professional		$416.87	$1,122.02	$3,311.31
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 / $14,125.38	Facility		$100.00	$100.00	$14,125.38
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $1,548.82 / $3,467.37	Professional		$380.19	$1,548.82	$3,467.37
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $9,332.54 / $14,125.38	Facility		$4,265.80	$9,332.54	$14,125.38
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $1,412.54 / $3,311.31	Professional		$416.87	$1,412.54	$3,311.31