Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.75 / $349.75 / $1,496.00	Facility		$349.75	$349.75	$1,496.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.75 / $386.39 / $616.52	Professional		$349.75	$386.39	$616.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $673.52 / $673.52 / $942.93	Professional		$673.52	$673.52	$942.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $615.04 / $720.49 / $1,866.72	Facility		$615.04	$720.49	$1,866.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $615.59 / $769.49 / $1,254.73	Professional		$615.59	$769.49	$1,254.73
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $763.33 / $763.33 / $763.33	Professional		$763.33	$763.33	$763.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $491.24 / $654.99 / $893.73	Facility		$491.24	$654.99	$893.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $458.49 / $643.48 / $1,402.46	Professional		$458.49	$643.48	$1,402.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $636.97 / $636.97 / $832.98	Facility		$636.97	$636.97	$832.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $464.99 / $464.99 / $748.13	Professional		$464.99	$464.99	$748.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $636.97 / $636.97 / $712.60	Facility		$636.97	$636.97	$712.60
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $464.99 / $636.97 / $636.97	Professional		$464.99	$636.97	$636.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $551.28 / $758.01 / $993.75	Professional		$551.28	$758.01	$993.75
United Facility/Professional Professional Modifier Low / Median / High Price $346.27 / $521.96 / $769.49	Professional		$346.27	$521.96	$769.49