Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,243.08 / $2,243.08 / $5,266.00	Facility		$2,243.08	$2,243.08	$5,266.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,103.48 / $2,243.08 / $3,216.10	Professional		$2,103.48	$2,243.08	$3,216.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3,445.37 / $3,445.37 / $3,445.37	Professional		$3,445.37	$3,445.37	$3,445.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,313.60 / $5,053.20 / $13,092.39	Facility		$4,313.60	$5,053.20	$13,092.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,241.00 / $2,469.21 / $5,971.96	Professional		$2,241.00	$2,469.21	$5,971.96
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $3,904.75 / $3,904.75 / $3,904.75	Professional		$3,904.75	$3,904.75	$3,904.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,217.29 / $4,593.82 / $6,201.66	Facility		$3,217.29	$4,593.82	$6,201.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,985.98 / $4,134.43 / $9,836.29	Professional		$2,985.98	$4,134.43	$9,836.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,550.04 / $2,550.04 / $5,194.84	Facility		$2,550.04	$2,550.04	$5,194.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,861.53 / $1,861.53 / $3,257.68	Professional		$1,861.53	$1,861.53	$3,257.68
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,550.04 / $2,550.04 / $2,550.04	Facility		$2,550.04	$2,550.04	$2,550.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,861.53 / $2,550.04 / $2,550.04	Professional		$1,861.53	$2,550.04	$2,550.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,483.56 / $3,414.89 / $4,476.92	Professional		$2,483.56	$3,414.89	$4,476.92
United Facility/Professional Facility Modifier Low / Median / High Price $4,625.10 / $4,625.10 / $5,441.30	Facility		$4,625.10	$4,625.10	$5,441.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,527.87 / $2,291.81 / $3,137.34	Professional		$1,527.87	$2,291.81	$3,137.34