Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.00 / $262.00 / $854.00	Facility		$262.00	$262.00	$854.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.38 / $262.00 / $338.94	Professional		$219.38	$262.00	$338.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $385.36 / $385.36 / $385.36	Professional		$385.36	$385.36	$385.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $458.04 / $536.58 / $1,390.23	Facility		$458.04	$536.58	$1,390.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.96 / $266.75 / $634.14	Professional		$237.96	$266.75	$634.14
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $414.63 / $414.63 / $414.63	Professional		$414.63	$414.63	$414.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $365.85 / $487.80 / $658.53	Facility		$365.85	$487.80	$658.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $337.21 / $466.90 / $1,044.48	Professional		$337.21	$466.90	$1,044.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.02 / $297.02 / $607.94	Facility		$297.02	$297.02	$607.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.82 / $216.82 / $405.60	Professional		$216.82	$216.82	$405.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $297.02 / $297.02 / $297.02	Facility		$297.02	$297.02	$297.02
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $216.82 / $297.02 / $297.02	Professional		$216.82	$297.02	$297.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $263.72 / $362.61 / $475.38	Professional		$263.72	$362.61	$475.38
United Facility/Professional Professional Modifier Low / Median / High Price $162.24 / $229.07 / $342.41	Professional		$162.24	$229.07	$342.41