Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $7,079.46 / $12,022.64	Facility		$1,905.46	$7,079.46	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $3,019.95	Professional		$1,071.52	$1,445.44	$3,019.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Professional		$1,023.29	$1,023.29	$1,023.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $16,982.44	Facility		$2,238.72	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,318.26 / $2,290.87	Professional		$1,023.29	$1,318.26	$2,290.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $2,630.27	Facility		$1,348.96	$1,348.96	$2,630.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional		$1,148.15	$1,148.15	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,137.96 / $21,379.62	Facility		$1,949.84	$2,137.96	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,479.11 / $2,398.83	Professional		$912.01	$1,479.11	$2,398.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $4,570.88 / $21,379.62	Facility		$1,949.84	$4,570.88	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,584.89 / $2,691.53	Professional		$954.99	$1,584.89	$2,691.53
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 / $1,148.15 / $5,128.61	Facility		$100.00	$1,148.15	$5,128.61
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,258.93 / $2,238.72	Professional		$977.24	$1,258.93	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $6,606.93 / $10,471.29	Facility		$2,884.03	$6,606.93	$10,471.29
United Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,288.25 / $2,187.76	Professional		$977.24	$1,288.25	$2,187.76