Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $3,715.35 / $12,022.64	Facility		$602.56	$3,715.35	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $977.24 / $3,467.37	Professional		$380.19	$977.24	$3,467.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $575.44 / $2,290.87	Professional		$380.19	$575.44	$2,290.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $7,413.10 / $30,199.52	Facility		$1,995.26	$7,413.10	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $851.14	Professional		$380.19	$512.86	$851.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $467.74 / $537.03	Facility		$389.05	$467.74	$537.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,630.27 / $3,019.95	Professional		$2,089.30	$2,630.27	$3,019.95
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 $426.58 / $776.25 / $3,388.44	Professional		$426.58	$776.25	$3,388.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,981.07 / $6,606.93	Facility		$2,238.72	$3,981.07	$6,606.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $794.33 / $3,388.44	Professional		$398.11	$794.33	$3,388.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $371.54	Professional		$32.36	$33.11	$371.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $7,762.47	Facility		$100.00	$100.00	$7,762.47
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $891.25 / $3,467.37	Professional		$380.19	$891.25	$3,467.37
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $9,332.54 / $14,791.08	Facility		$4,265.80	$9,332.54	$14,791.08
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $1,096.48 / $2,691.53	Professional		$354.81	$1,096.48	$2,691.53