Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,023.29 / $4,786.30	Facility		$575.44	$1,023.29	$4,786.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $562.34 / $812.83	Professional		$426.58	$562.34	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $794.33 / $870.96	Professional		$426.58	$794.33	$870.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,148.15 / $2,344.23	Facility		$1,096.48	$1,148.15	$2,344.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $630.96 / $1,380.38	Professional		$524.81	$630.96	$1,380.38
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Professional		$912.01	$912.01	$912.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $812.83 / $1,288.25	Facility		$537.03	$812.83	$1,288.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $977.24 / $1,445.44	Professional		$707.95	$977.24	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $851.14	Facility		$724.44	$724.44	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $724.44	Professional		$537.03	$537.03	$724.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $1,479.11	Facility		$724.44	$724.44	$1,479.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $707.95	Professional		$537.03	$537.03	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $831.76 / $1,202.26	Professional		$602.56	$831.76	$1,202.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,230.27 / $2,238.72	Professional		$1,096.48	$1,230.27	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $524.81 / $1,122.02	Facility		$371.54	$524.81	$1,122.02
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $512.86 / $741.31	Professional		$354.81	$512.86	$741.31