Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $645.65 / $1,202.26	Facility		$245.47	$645.65	$1,202.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $602.56	Professional		$199.53	$263.03	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $354.81 / $537.03	Professional		$346.74	$354.81	$537.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $467.74	Professional		$144.54	$199.53	$467.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $257.04 / $275.42	Facility		$199.53	$257.04	$275.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $467.74	Professional		$194.98	$245.47	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $478.63	Facility		$263.03	$263.03	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $269.15 / $588.84	Professional		$194.98	$269.15	$588.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $812.83 / $1,513.56	Facility		$416.87	$812.83	$1,513.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $245.47 / $446.68	Professional		$186.21	$245.47	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $302.00	Professional		$151.36	$245.47	$302.00
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $812.83	Professional		$346.74	$501.19	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $1,318.26	Facility		$199.53	$199.53	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $245.47 / $446.68	Professional		$134.90	$245.47	$446.68