Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $8,912.51 / $15,135.61	Facility		$1,995.26	$8,912.51	$15,135.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,380.38 / $4,265.80	Professional		$1,023.29	$1,380.38	$4,265.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $912.01 / $1,862.09	Professional		$831.76	$912.01	$1,862.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $6,025.60 / $30,199.52	Facility		$2,187.76	$6,025.60	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $2,238.72	Professional		$912.01	$1,230.27	$2,238.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,096.48 / $1,258.93	Facility		$1,047.13	$1,096.48	$1,258.93
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 / $1,445.44 / $2,238.72	Professional		$389.05	$1,445.44	$2,238.72
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 / $1,479.11 / $2,290.87	Professional		$389.05	$1,479.11	$2,290.87
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 / $13,182.57	Facility		$100.00	$100.00	$13,182.57
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,174.90 / $2,238.72	Professional		$1,000.00	$1,174.90	$2,238.72
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 $977.24 / $1,288.25 / $2,290.87	Professional		$977.24	$1,288.25	$2,290.87