Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $401.15 / $401.15 / $1,003.00	Facility		$401.15	$401.15	$1,003.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.81 / $401.15 / $518.94	Professional		$320.81	$401.15	$518.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $420.11 / $560.15 / $590.02	Professional		$420.11	$560.15	$590.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $701.30 / $821.55 / $2,128.55	Facility		$701.30	$821.55	$2,128.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $364.34 / $376.03 / $970.91	Professional		$364.34	$376.03	$970.91
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $634.83 / $634.83 / $672.17	Professional		$634.83	$634.83	$672.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $499.61 / $746.86 / $1,008.26	Facility		$499.61	$746.86	$1,008.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $485.46 / $672.17 / $1,599.18	Professional		$485.46	$672.17	$1,599.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $523.66 / $523.66 / $825.57	Facility		$523.66	$523.66	$825.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.28 / $382.28 / $621.01	Professional		$382.28	$382.28	$621.01
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $523.66 / $523.66 / $523.66	Facility		$523.66	$523.66	$523.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $382.28 / $445.10 / $523.66	Professional		$382.28	$445.10	$523.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $403.77 / $555.19 / $727.85	Professional		$403.77	$555.19	$727.85
United Facility/Professional Professional Modifier Low / Median / High Price $234.41 / $337.50 / $477.07	Professional		$234.41	$337.50	$477.07