Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $549.54	Facility		$363.08	$363.08	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $575.44	Professional		$281.84	$363.08	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $794.33 / $1,621.81	Facility		$758.58	$794.33	$1,621.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $436.52 / $977.24	Professional		$371.54	$436.52	$977.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $489.78 / $794.33	Facility		$331.13	$489.78	$794.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $588.84 / $891.25	Professional		$426.58	$588.84	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $407.38	Professional		$302.00	$302.00	$407.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $407.38	Professional		$302.00	$302.00	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $457.09 / $660.69	Professional		$323.59	$457.09	$660.69
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $851.14 / $1,548.82	Professional		$758.58	$851.14	$1,548.82
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $489.78 / $758.58	Facility		$275.42	$489.78	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $371.54 / $501.19	Professional		$245.47	$371.54	$501.19