Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $3,162.28 / $10,715.19	Facility		$691.83	$3,162.28	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $630.96 / $1,513.56	Professional		$457.09	$630.96	$1,513.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $3,019.95 / $7,943.28	Facility		$1,000.00	$3,019.95	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $562.34 / $1,023.29	Professional		$407.38	$562.34	$1,023.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $1,513.56	Facility		$575.44	$575.44	$1,513.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,258.93 / $21,379.62	Facility		$1,122.02	$1,258.93	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $660.69 / $1,258.93	Professional		$436.52	$660.69	$1,258.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,258.93 / $21,379.62	Facility		$1,122.02	$1,258.93	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $707.95 / $1,258.93	Professional		$446.68	$707.95	$1,258.93
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 / $645.65 / $2,818.38	Facility		$100.00	$645.65	$2,818.38
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $660.69 / $1,202.26	Professional		$436.52	$660.69	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $4,265.80 / $7,244.36	Facility		$1,737.80	$4,265.80	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $602.56 / $1,047.13	Professional		$416.87	$602.56	$1,047.13