Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $838.38 / $838.38 / $2,825.34	Facility		$838.38	$838.38	$2,825.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $618.51 / $834.64 / $891.42	Professional		$618.51	$834.64	$891.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,170.68 / $1,170.68 / $1,170.68	Professional		$1,170.68	$1,170.68	$1,170.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,465.69 / $1,717.00 / $4,448.59	Facility		$1,465.69	$1,717.00	$4,448.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $609.16 / $765.53 / $2,051.03	Professional		$609.16	$765.53	$2,051.03
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,326.77 / $1,326.77 / $1,404.82	Professional		$1,326.77	$1,326.77	$1,404.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,073.83 / $1,560.91 / $2,107.23	Facility		$1,073.83	$1,560.91	$2,107.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,071.93 / $1,484.21 / $3,342.22	Professional		$1,071.93	$1,484.21	$3,342.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.54 / $906.54 / $1,932.56	Facility		$906.54	$906.54	$1,932.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $661.77 / $661.77 / $1,158.09	Professional		$661.77	$661.77	$1,158.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $906.54 / $906.54 / $906.54	Facility		$906.54	$906.54	$906.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $661.77 / $906.54 / $906.54	Professional		$661.77	$906.54	$906.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $832.00 / $1,144.00 / $1,499.78	Professional		$832.00	$1,144.00	$1,499.78
United Facility/Professional Professional Modifier Low / Median / High Price $474.70 / $712.05 / $990.81	Professional		$474.70	$712.05	$990.81