Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,148.15 / $1,412.54	Facility		$794.33	$1,148.15	$1,412.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $776.25 / $1,122.02	Professional		$588.84	$776.25	$1,122.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Professional		$1,096.48	$1,096.48	$1,096.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,584.89 / $3,235.94	Facility		$1,513.56	$1,584.89	$3,235.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $870.96 / $1,949.84	Professional		$724.44	$870.96	$1,949.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,122.02 / $1,778.28	Facility		$741.31	$1,122.02	$1,778.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,348.96 / $2,041.74	Professional		$977.24	$1,348.96	$2,041.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $831.76	Professional		$602.56	$602.56	$831.76
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $2,041.74	Facility		$831.76	$831.76	$2,041.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $831.76	Professional		$602.56	$602.56	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,288.25 / $1,862.09	Professional		$812.83	$1,288.25	$1,862.09
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility		$1,819.70	$1,819.70	$1,819.70
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,698.24 / $3,162.28	Professional		$1,513.56	$1,698.24	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $724.44 / $1,548.82	Facility		$512.86	$724.44	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $707.95 / $1,023.29	Professional		$489.78	$707.95	$1,023.29