Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $351.99 / $351.99 / $1,680.00	Facility		$351.99	$351.99	$1,680.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.99 / $402.64 / $692.12	Professional		$351.99	$402.64	$692.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,006.69 / $1,006.69 / $1,107.35	Professional		$1,006.69	$1,006.69	$1,107.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $618.98 / $725.11 / $1,878.69	Facility		$618.98	$725.11	$1,878.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $464.67 / $691.19 / $1,130.95	Professional		$464.67	$691.19	$1,130.95
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $855.69 / $855.69 / $855.69	Professional		$855.69	$855.69	$855.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $494.39 / $660.05 / $922.87	Facility		$494.39	$660.05	$922.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $461.43 / $659.19 / $1,411.46	Professional		$461.43	$659.19	$1,411.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.68 / $758.68 / $904.69	Facility		$758.68	$758.68	$904.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $553.84 / $553.84 / $786.60	Professional		$553.84	$553.84	$786.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $758.68 / $758.68 / $758.68	Facility		$758.68	$758.68	$758.68
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $553.84 / $758.68 / $758.68	Professional		$553.84	$758.68	$758.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $704.00 / $968.00 / $1,269.04	Professional		$704.00	$968.00	$1,269.04
United Facility/Professional Professional Modifier Low / Median / High Price $411.37 / $602.27 / $830.77	Professional		$411.37	$602.27	$830.77