Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $733.67 / $1,856.19 / $3,957.53	Facility		$733.67	$1,856.19	$3,957.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $734.15 / $1,007.54	Professional		$733.67	$734.15	$1,007.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $705.14 / $705.14 / $733.67	Professional		$705.14	$705.14	$733.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $792.36 / $1,181.21 / $1,834.18	Facility		$792.36	$1,181.21	$1,834.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $821.71 / $1,221.56	Professional		$733.67	$821.71	$1,221.56
Aultcare Facility/Professional Facility Modifier Low / Median / High Price $1,738.80 / $1,738.80 / $1,738.80	Facility		$1,738.80	$1,738.80	$1,738.80
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $733.67 / $733.67	Professional		$733.67	$733.67	$733.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $733.67 / $734.15 / $1,101.23	Facility		$733.67	$734.15	$1,101.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $734.15 / $1,173.86	Professional		$733.67	$734.15	$1,173.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $692.14 / $733.67 / $1,012.41	Facility		$692.14	$733.67	$1,012.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $733.67 / $1,038.21	Professional		$733.67	$733.67	$1,038.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $692.14 / $1,012.41 / $2,547.27	Facility		$692.14	$1,012.41	$2,547.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $733.67 / $1,259.41	Professional		$733.67	$733.67	$1,259.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $843.72 / $1,022.45	Professional		$733.67	$843.72	$1,022.45
United Facility/Professional Professional Modifier Low / Median / High Price $732.28 / $733.67 / $909.24	Professional		$732.28	$733.67	$909.24