Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $7,585.78 / $12,022.64	Facility		$2,398.83	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,445.44 / $6,918.31	Professional		$1,148.15	$1,445.44	$6,918.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Professional		$2,398.83	$2,398.83	$2,398.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $6,918.31 / $30,199.52	Facility		$2,137.96	$6,918.31	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,380.38 / $2,511.89	Professional		$977.24	$1,380.38	$2,511.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,288.25 / $1,479.11	Facility		$1,230.27	$1,288.25	$1,479.11
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 $389.05 / $1,698.24 / $2,630.27	Professional		$389.05	$1,698.24	$2,630.27
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 $389.05 / $1,737.80 / $2,691.53	Professional		$389.05	$1,737.80	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $9,120.11	Facility		$100.00	$100.00	$9,120.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,380.38 / $2,630.27	Professional		$1,174.90	$1,380.38	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,606.93 / $10,964.78	Facility		$3,890.45	$6,606.93	$10,964.78
United Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,513.56 / $2,691.53	Professional		$1,148.15	$1,513.56	$2,691.53