Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $912.01	Facility		$562.34	$562.34	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $602.56 / $912.01	Professional		$478.63	$602.56	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $812.83 / $1,202.26	Facility		$776.25	$812.83	$1,202.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $954.99 / $1,737.80	Professional		$676.08	$954.99	$1,737.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $616.60 / $831.76	Facility		$83.18	$616.60	$831.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $478.63 / $870.96	Professional		$64.57	$478.63	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $295.12 / $977.24	Professional		$66.07	$295.12	$977.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $112.20 / $977.24	Professional		$74.13	$112.20	$977.24
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,348.96 / $2,454.71	Professional		$1,047.13	$1,348.96	$2,454.71
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $79.43 / $794.33	Facility		$39.81	$79.43	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,174.90 / $1,949.84	Professional		$309.03	$1,174.90	$1,949.84