Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,479.11 / $4,265.80	Facility		$1,122.02	$1,479.11	$4,265.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,412.54 / $3,019.95	Professional		$1,071.52	$1,412.54	$3,019.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Professional		$1,318.26	$1,318.26	$1,318.26
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 $1,148.15 / $1,548.82 / $2,818.38	Professional		$1,148.15	$1,548.82	$2,818.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,348.96 / $1,584.89	Facility		$1,318.26	$1,348.96	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,380.38 / $21,379.62	Facility		$1,096.48	$1,380.38	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $1,737.80 / $2,570.40	Professional		$194.98	$1,737.80	$2,570.40
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 $194.98 / $1,737.80 / $2,630.27	Professional		$194.98	$1,737.80	$2,630.27
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 $1,318.26 / $1,548.82 / $2,884.03	Professional		$1,318.26	$1,548.82	$2,884.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,951.21 / $6,760.83	Facility		$1,258.93	$2,951.21	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,445.44 / $2,238.72	Professional		$1,096.48	$1,445.44	$2,238.72