Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $6,606.93 / $12,302.69	Facility		$549.54	$6,606.93	$12,302.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $1,071.52 / $2,754.23	Professional		$288.40	$1,071.52	$2,754.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $131.83	Professional		$128.82	$128.82	$131.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $5,888.44 / $15,135.61	Facility		$1,949.84	$5,888.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,122.02 / $2,137.96	Professional		$309.03	$1,122.02	$2,137.96
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $1,174.90 / $21,379.62	Facility		$245.47	$1,174.90	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $630.96 / $2,089.30	Professional		$295.12	$630.96	$2,089.30
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 $302.00 / $707.95 / $2,137.96	Professional		$302.00	$707.95	$2,137.96
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 / $6,918.31	Facility		$100.00	$100.00	$6,918.31
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $776.25 / $2,398.83	Professional		$281.84	$776.25	$2,398.83
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $9,332.54 / $13,803.84	Facility		$4,265.80	$9,332.54	$13,803.84
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,122.02 / $2,454.71	Professional		$309.03	$1,122.02	$2,454.71