Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $537.03 / $1,174.90	Facility		$346.74	$537.03	$1,174.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $630.96 / $1,148.15	Professional		$371.54	$630.96	$1,148.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $707.95	Professional		$426.58	$501.19	$707.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,137.96 / $2,511.89	Facility		$1,318.26	$2,137.96	$2,511.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $549.54 / $954.99	Professional		$398.11	$549.54	$954.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $549.54 / $575.44	Facility		$416.87	$549.54	$575.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $724.44 / $1,288.25	Professional		$630.96	$724.44	$1,288.25
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 $398.11 / $602.56 / $954.99	Professional		$398.11	$602.56	$954.99
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 $398.11 / $630.96 / $954.99	Professional		$398.11	$630.96	$954.99
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 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $616.60 / $933.25	Professional		$407.38	$616.60	$933.25
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $2,951.21 / $6,760.83	Facility		$1,047.13	$2,951.21	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $478.63 / $794.33	Professional		$323.59	$478.63	$794.33