Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $447.91 / $447.91 / $1,557.00	Facility		$447.91	$447.91	$1,557.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $386.07 / $447.91 / $575.71	Professional		$386.07	$447.91	$575.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $469.09 / $469.09 / $625.45	Professional		$469.09	$469.09	$625.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $783.06 / $917.32 / $2,376.69	Facility		$783.06	$917.32	$2,376.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $406.82 / $467.84 / $1,100.78	Professional		$406.82	$467.84	$1,100.78
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $708.84 / $708.84 / $750.54	Professional		$708.84	$708.84	$750.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $625.45 / $833.93 / $1,125.81	Facility		$625.45	$833.93	$1,125.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $583.75 / $831.27 / $1,785.61	Professional		$583.75	$831.27	$1,785.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $544.74 / $544.74 / $1,082.38	Facility		$544.74	$544.74	$1,082.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.66 / $397.66 / $693.39	Professional		$397.66	$397.66	$693.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $544.74 / $544.74 / $544.74	Facility		$544.74	$544.74	$544.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $397.66 / $544.74 / $544.74	Professional		$397.66	$544.74	$544.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $450.84 / $619.91 / $812.70	Professional		$450.84	$619.91	$812.70
United Facility/Professional Professional Modifier Low / Median / High Price $277.36 / $403.06 / $604.58	Professional		$277.36	$403.06	$604.58