Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,579.26 / $1,579.26 / $3,798.00	Facility		$1,579.26	$1,579.26	$3,798.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,351.32 / $1,579.26 / $2,110.19	Professional		$1,351.32	$1,579.26	$2,110.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,425.73 / $2,425.73 / $2,425.73	Professional		$2,425.73	$2,425.73	$2,425.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,037.03 / $3,557.75 / $9,217.81	Facility		$3,037.03	$3,557.75	$9,217.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,577.81 / $1,754.52 / $4,204.60	Professional		$1,577.81	$1,754.52	$4,204.60
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $2,749.17 / $2,749.17 / $2,749.17	Professional		$2,749.17	$2,749.17	$2,749.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,342.42 / $3,234.32 / $4,366.33	Facility		$2,342.42	$3,234.32	$4,366.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,145.98 / $2,971.37 / $6,925.33	Professional		$2,145.98	$2,971.37	$6,925.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,721.98 / $1,721.98 / $3,868.97	Facility		$1,721.98	$1,721.98	$3,868.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,257.05 / $1,257.05 / $2,199.83	Professional		$1,257.05	$1,257.05	$2,199.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,721.98 / $1,721.98 / $1,721.98	Facility		$1,721.98	$1,721.98	$1,721.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,257.05 / $1,721.98 / $1,721.98	Professional		$1,257.05	$1,721.98	$1,721.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,748.57 / $2,404.29 / $3,152.02	Professional		$1,748.57	$2,404.29	$3,152.02
United Facility/Professional Facility Modifier Low / Median / High Price $3,123.22 / $3,123.22 / $3,674.38	Facility		$3,123.22	$3,123.22	$3,674.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,075.71 / $1,613.57 / $2,118.58	Professional		$1,075.71	$1,613.57	$2,118.58