Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $7,413.10 / $13,803.84	Facility		$1,288.25	$7,413.10	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $741.31 / $1,905.46	Professional		$616.60	$741.31	$1,905.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Professional		$870.96	$870.96	$870.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $4,570.88 / $21,877.62	Facility		$1,412.54	$4,570.88	$21,877.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $724.44 / $1,148.15	Professional		$562.34	$724.44	$1,148.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $707.95 / $3,630.78	Facility		$645.65	$707.95	$3,630.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $794.33	Professional		$707.95	$707.95	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $1,148.15 / $4,365.16	Facility		$34.67	$1,148.15	$4,365.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $891.25 / $1,445.44	Professional		$562.34	$891.25	$1,445.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $1,148.15 / $4,365.16	Facility		$562.34	$1,148.15	$4,365.16
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $870.96 / $1,380.38	Professional		$524.81	$870.96	$1,380.38
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 / $7,413.10	Facility		$100.00	$100.00	$7,413.10
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $776.25 / $1,445.44	Professional		$660.69	$776.25	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $8,128.31 / $14,125.38	Facility		$1,288.25	$8,128.31	$14,125.38
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $758.58 / $1,230.27	Professional		$549.54	$758.58	$1,230.27