Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $9,120.11 / $12,022.64	Facility		$2,754.23	$9,120.11	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,090.30 / $7,762.47	Professional		$2,454.71	$3,090.30	$7,762.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Professional		$3,548.13	$3,548.13	$3,548.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $12,302.69 / $30,199.52	Facility		$3,388.44	$12,302.69	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,951.21 / $4,677.35	Professional		$2,238.72	$2,951.21	$4,677.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $3,162.28	Facility		$2,691.53	$2,691.53	$3,162.28
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 $2,570.40 / $3,715.35 / $5,495.41	Professional		$2,570.40	$3,715.35	$5,495.41
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 $2,398.83 / $3,715.35 / $5,623.41	Professional		$2,398.83	$3,715.35	$5,623.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$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 $2,691.53 / $3,162.28 / $6,025.60	Professional		$2,691.53	$3,162.28	$6,025.60
United Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $11,220.18 / $15,848.93	Facility		$5,370.32	$11,220.18	$15,848.93
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,090.30 / $4,897.79	Professional		$1,995.26	$3,090.30	$4,897.79