Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $642.08 / $4,811.20 / $9,504.00	Facility		$642.08	$4,811.20	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $377.70 / $1,169.08 / $2,658.21	Professional		$377.70	$1,169.08	$2,658.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $387.97 / $387.97 / $387.97	Professional		$387.97	$387.97	$387.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,528.00 / $14,996.00	Facility		$1,760.00	$3,528.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.17 / $1,180.29 / $2,355.09	Professional		$349.17	$1,180.29	$2,355.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $329.77 / $329.77 / $480.20	Facility		$329.77	$329.77	$480.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,134.61 / $1,414.29 / $1,414.29	Professional		$1,134.61	$1,414.29	$1,414.29
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 $342.84 / $772.64 / $2,482.32	Professional		$342.84	$772.64	$2,482.32
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $6,030.87 / $6,030.87 / $6,030.87	Facility		$6,030.87	$6,030.87	$6,030.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $387.97 / $835.69 / $2,445.78	Professional		$387.97	$835.69	$2,445.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,207.27 / $1,601.15 / $2,178.95	Professional		$1,207.27	$1,601.15	$2,178.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,998.00 / $7,821.00	Facility		$2,840.00	$5,998.00	$7,821.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,487.97 / $2,001.31 / $3,074.62	Professional		$1,487.97	$2,001.31	$3,074.62