Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $524.81 / $794.33	Professional		$398.11	$524.81	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $407.38	Professional		$331.13	$331.13	$407.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $676.08 / $1,621.81	Professional		$616.60	$676.08	$1,621.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $83.18 / $794.33	Facility		$41.69	$83.18	$794.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $794.33	Professional		$53.70	$75.86	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $691.83	Facility		$616.60	$616.60	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $691.83	Professional		$524.81	$524.81	$691.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $724.44	Facility		$616.60	$616.60	$724.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $54.95 / $616.60	Professional		$38.90	$54.95	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $204.17 / $1,380.38	Professional		$83.18	$204.17	$1,380.38
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,230.27 / $2,041.74	Professional		$1,047.13	$1,230.27	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $346.74 / $562.34	Facility		$51.29	$346.74	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $407.38 / $602.56	Professional		$239.88	$407.38	$602.56