Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $512.86 / $758.58	Facility		$331.13	$512.86	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $467.74 / $741.31	Professional		$323.59	$467.74	$741.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $912.01 / $1,698.24	Professional		$549.54	$912.01	$1,698.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $676.08 / $1,380.38	Facility		$645.65	$676.08	$1,380.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $812.83 / $1,380.38	Professional		$660.69	$812.83	$1,380.38
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $741.31	Professional		$724.44	$724.44	$741.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $512.86 / $812.83	Facility		$338.84	$512.86	$812.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $616.60 / $912.01	Professional		$446.68	$616.60	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $645.65 / $645.65	Facility		$616.60	$645.65	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $616.60	Professional		$467.74	$467.74	$616.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $645.65 / $954.99	Facility		$616.60	$645.65	$954.99
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $954.99	Professional		$467.74	$467.74	$954.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $741.31 / $1,071.52	Professional		$524.81	$741.31	$1,071.52
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $954.99 / $1,995.26	Professional		$776.25	$954.99	$1,995.26
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $501.19 / $794.33	Facility		$363.08	$501.19	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $478.63 / $741.31	Professional		$309.03	$478.63	$741.31