Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $880.99 / $1,905.00 / $3,376.67	Facility		$880.99	$1,905.00	$3,376.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $958.30 / $1,214.63 / $2,473.55	Professional		$958.30	$1,214.63	$2,473.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,166.05 / $1,166.05 / $1,166.05	Professional		$1,166.05	$1,166.05	$1,166.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,821.95 / $2,842.23 / $7,895.10	Facility		$1,821.95	$2,842.23	$7,895.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,156.28 / $1,214.63 / $2,004.13	Professional		$1,156.28	$1,214.63	$2,004.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,754.53 / $2,982.70	Facility		$1,238.93	$1,754.53	$2,982.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,205.22 / $1,238.93 / $1,721.74	Professional		$1,205.22	$1,238.93	$1,721.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Facility		$1,238.93	$1,238.93	$1,238.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,238.93 / $1,518.28	Professional		$1,214.63	$1,238.93	$1,518.28
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $841.71 / $1,238.93 / $2,616.05	Facility		$841.71	$1,238.93	$2,616.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,457.56	Professional		$1,238.93	$1,238.93	$1,457.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,299.65 / $1,949.47 / $2,837.91	Professional		$1,299.65	$1,949.47	$2,837.91
United Facility/Professional Professional Modifier Low / Median / High Price $485.85 / $1,214.63 / $1,311.80	Professional		$485.85	$1,214.63	$1,311.80