Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $724.44 / $912.01	Professional		$549.54	$724.44	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,071.52 / $1,479.11	Facility		$1,000.00	$1,071.52	$1,479.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $912.01 / $1,621.81	Professional		$10.72	$912.01	$1,621.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $97.72 / $758.58	Facility		$56.23	$97.72	$758.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $912.01	Professional		$72.44	$100.00	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $812.83	Facility		$251.19	$251.19	$812.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $1,348.96	Professional		$213.80	$213.80	$1,348.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $1,148.15	Facility		$251.19	$251.19	$1,148.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $213.80 / $251.19	Professional		$87.10	$213.80	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $933.25 / $1,380.38	Professional		$562.34	$933.25	$1,380.38
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,288.25 / $2,187.76	Professional		$1,096.48	$1,288.25	$2,187.76
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $407.38 / $676.08	Facility		$53.70	$407.38	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $426.58 / $741.31	Professional		$234.42	$426.58	$741.31