Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $1,621.81 / $3,890.45	Facility		$269.15	$1,621.81	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $213.80 / $354.81	Professional		$138.04	$213.80	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $190.55	Professional		$134.90	$134.90	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $501.19	Professional		$114.82	$169.82	$501.19
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $257.04 / $302.00	Facility		$251.19	$257.04	$302.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $436.52	Facility		$426.58	$426.58	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $616.60	Professional		$213.80	$302.00	$616.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,513.56 / $3,890.45	Facility		$467.74	$1,513.56	$3,890.45
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $602.56	Professional		$213.80	$295.12	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $181.97 / $263.03	Professional		$123.03	$181.97	$263.03
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $218.78 / $416.87	Professional		$177.83	$218.78	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $891.25	Facility		$741.31	$741.31	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $134.90 / $316.23	Professional		$72.44	$134.90	$316.23