Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $660.69	Facility		$288.40	$288.40	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $575.44	Professional		$257.04	$316.23	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $524.81 / $707.95	Professional		$407.38	$524.81	$707.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $645.65 / $1,288.25	Facility		$602.56	$645.65	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $389.05 / $776.25	Professional		$288.40	$389.05	$776.25
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $512.86 / $831.76	Facility		$346.74	$512.86	$831.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $616.60 / $933.25	Professional		$446.68	$616.60	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $380.19	Professional		$275.42	$275.42	$380.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $380.19	Professional		$275.42	$275.42	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $660.69	Professional		$331.13	$467.74	$660.69
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $676.08 / $1,258.93	Professional		$602.56	$676.08	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $446.68 / $691.83	Facility		$245.47	$446.68	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $457.09	Professional		$199.53	$295.12	$457.09