Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $2,570.40 / $10,715.19	Facility		$489.78	$2,570.40	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $371.54 / $1,202.26	Professional		$281.84	$371.54	$1,202.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $162.18	Professional		$154.88	$154.88	$162.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,754.23 / $7,943.28	Facility		$1,000.00	$2,754.23	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $371.54 / $575.44	Professional		$281.84	$371.54	$575.44
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $371.54	Facility		$316.23	$316.23	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $524.81 / $21,379.62	Facility		$380.19	$524.81	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $436.52 / $616.60	Professional		$302.00	$436.52	$616.60
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 $281.84 / $436.52 / $630.96	Professional		$281.84	$436.52	$630.96
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 / $2,398.83	Facility		$100.00	$100.00	$2,398.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $363.08 / $691.83	Professional		$309.03	$363.08	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $7,244.36	Facility		$2,238.72	$4,365.16	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $363.08 / $562.34	Professional		$239.88	$363.08	$562.34