Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $961.94 / $961.94 / $2,983.00	Facility		$961.94	$961.94	$2,983.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $841.84 / $961.94 / $1,102.05	Professional		$841.84	$961.94	$1,102.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,343.23 / $1,343.23 / $1,343.23	Professional		$1,343.23	$1,343.23	$1,343.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,681.72 / $1,970.07 / $5,104.26	Facility		$1,681.72	$1,970.07	$5,104.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $873.69 / $968.81 / $2,328.26	Professional		$873.69	$968.81	$2,328.26
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,522.32 / $1,522.32 / $1,522.32	Professional		$1,522.32	$1,522.32	$1,522.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,343.23 / $1,790.97 / $2,417.81	Facility		$1,343.23	$1,790.97	$2,417.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,170.41 / $1,620.57 / $3,834.82	Professional		$1,170.41	$1,620.57	$3,834.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,162.20 / $1,162.20 / $1,433.06	Facility		$1,162.20	$1,162.20	$1,433.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $848.41 / $848.41 / $1,433.06	Professional		$848.41	$848.41	$1,433.06
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,162.20 / $1,162.20 / $1,433.06	Facility		$1,162.20	$1,162.20	$1,433.06
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $848.41 / $1,162.20 / $1,167.97	Professional		$848.41	$1,162.20	$1,167.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $960.00 / $1,320.00 / $1,730.52	Professional		$960.00	$1,320.00	$1,730.52
United Facility/Professional Professional Modifier Low / Median / High Price $595.66 / $856.19 / $1,202.59	Professional		$595.66	$856.19	$1,202.59