Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $1,258.93 / $3,801.89	Facility		$107.15	$1,258.93	$3,801.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $1,995.26	Professional		$912.01	$1,230.27	$1,995.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,174.90 / $1,819.70	Professional		$870.96	$1,174.90	$1,819.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,548.13 / $15,135.61	Facility		$1,698.24	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,513.56 / $2,691.53	Professional		$1,096.48	$1,513.56	$2,691.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,148.15 / $1,348.96	Facility		$1,122.02	$1,148.15	$1,348.96
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 $331.13 / $1,445.44 / $2,238.72	Professional		$331.13	$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 $331.13 / $1,479.11 / $2,238.72	Professional		$331.13	$1,479.11	$2,238.72
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 $1,096.48 / $1,288.25 / $2,454.71	Professional		$1,096.48	$1,288.25	$2,454.71
United Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $2,951.21 / $6,760.83	Facility		$1,071.52	$2,951.21	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,258.93 / $1,949.84	Professional		$954.99	$1,258.93	$1,949.84