Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $463.30 / $463.30 / $1,036.00	Facility		$463.30	$463.30	$1,036.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.49 / $463.30 / $607.60	Professional		$413.49	$463.30	$607.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $523.90 / $711.63 / $749.59	Professional		$523.90	$711.63	$749.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $890.96 / $1,043.72 / $2,704.19	Facility		$890.96	$1,043.72	$2,704.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $462.86 / $510.00 / $1,233.49	Professional		$462.86	$510.00	$1,233.49
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $806.51 / $806.51 / $806.51	Professional		$806.51	$806.51	$806.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $640.08 / $948.84 / $1,280.93	Facility		$640.08	$948.84	$1,280.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $616.75 / $853.96 / $2,031.66	Professional		$616.75	$853.96	$2,031.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.15 / $501.15 / $1,029.42	Facility		$501.15	$501.15	$1,029.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.84 / $365.84 / $640.22	Professional		$365.84	$365.84	$640.22
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $501.15 / $501.15 / $501.15	Facility		$501.15	$501.15	$501.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $365.84 / $501.15 / $501.15	Professional		$365.84	$501.15	$501.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $596.00 / $819.50 / $1,074.36	Professional		$596.00	$819.50	$1,074.36
United Facility/Professional Professional Modifier Low / Median / High Price $315.58 / $473.36 / $616.57	Professional		$315.58	$473.36	$616.57