Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $838.25 / $838.25 / $1,838.00	Facility		$838.25	$838.25	$1,838.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $706.79 / $838.25 / $980.41	Professional		$706.79	$838.25	$980.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,287.55 / $1,287.55 / $1,287.55	Professional		$1,287.55	$1,287.55	$1,287.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,612.01 / $1,888.40 / $4,892.68	Facility		$1,612.01	$1,888.40	$4,892.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $837.49 / $874.06 / $2,231.73	Professional		$837.49	$874.06	$2,231.73
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,459.22 / $1,459.22 / $1,459.22	Professional		$1,459.22	$1,459.22	$1,459.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,115.86 / $1,716.73 / $2,317.59	Facility		$1,115.86	$1,716.73	$2,317.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,115.86 / $1,545.06 / $3,675.86	Professional		$1,115.86	$1,545.06	$3,675.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,200.11 / $1,200.11 / $1,862.15	Facility		$1,200.11	$1,200.11	$1,862.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $876.09 / $876.09 / $1,427.44	Professional		$876.09	$876.09	$1,427.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,200.11 / $1,200.11 / $1,200.11	Facility		$1,200.11	$1,200.11	$1,200.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $876.09 / $1,200.11 / $1,200.11	Professional		$876.09	$1,200.11	$1,200.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $928.12 / $1,276.16 / $1,673.05	Professional		$928.12	$1,276.16	$1,673.05
United Facility/Professional Professional Modifier Low / Median / High Price $570.98 / $856.46 / $1,108.09	Professional		$570.98	$856.46	$1,108.09