Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $6,456.54 / $14,791.08	Facility		$302.00	$6,456.54	$14,791.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $407.38 / $1,905.46	Professional		$190.55	$407.38	$1,905.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $218.78 / $371.54	Professional		$190.55	$218.78	$371.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,137.96 / $2,511.89	Facility		$1,905.46	$2,137.96	$2,511.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $478.63	Professional		$194.98	$275.42	$478.63
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $338.84	Professional		$218.78	$218.78	$338.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $257.04 / $331.13	Facility		$199.53	$257.04	$331.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $269.15 / $478.63	Professional		$199.53	$269.15	$478.63
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 $199.53 / $295.12 / $446.68	Professional		$199.53	$295.12	$446.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $4,365.16 / $5,623.41	Facility		$1,318.26	$4,365.16	$5,623.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $446.68	Professional		$194.98	$288.40	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $46.77	Professional		$32.36	$33.11	$46.77
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 $194.98 / $239.88 / $426.58	Professional		$194.98	$239.88	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $245.47 / $380.19	Professional		$158.49	$245.47	$380.19