Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $4,265.80 / $8,317.64	Facility		$1,148.15	$4,265.80	$8,317.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,630.27 / $3,090.30	Professional		$2,511.89	$2,630.27	$3,090.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Professional		$1,905.46	$1,905.46	$1,905.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $3,467.37 / $8,709.64	Facility		$1,513.56	$3,467.37	$8,709.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,951.21 / $4,466.84	Professional		$2,398.83	$2,951.21	$4,466.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility		$2,630.27	$2,630.27	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $3,090.30	Professional		$2,630.27	$2,630.27	$3,090.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,630.27 / $4,677.35	Facility		$2,290.87	$2,630.27	$4,677.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $3,090.30	Professional		$2,630.27	$2,630.27	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,801.89 / $6,309.57	Professional		$2,754.23	$3,801.89	$6,309.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,570.40 / $2,884.03	Professional		$2,454.71	$2,570.40	$2,884.03