Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $439.45 / $439.45 / $1,276.00	Facility		$439.45	$439.45	$1,276.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $423.18 / $439.45 / $599.24	Professional		$423.18	$439.45	$599.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $674.99 / $674.99 / $674.99	Professional		$674.99	$674.99	$674.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $845.09 / $989.99 / $2,564.96	Facility		$845.09	$989.99	$2,564.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $450.91 / $518.34 / $1,169.98	Professional		$450.91	$518.34	$1,169.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $647.25 / $899.99 / $1,214.99	Facility		$647.25	$899.99	$1,214.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $584.99 / $809.99 / $1,927.06	Professional		$584.99	$809.99	$1,927.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $582.20 / $582.20 / $1,099.24	Facility		$582.20	$582.20	$1,099.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.01 / $425.01 / $601.36	Professional		$425.01	$425.01	$601.36
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $582.20 / $582.20 / $582.20	Facility		$582.20	$582.20	$582.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $425.01 / $582.20 / $582.20	Professional		$425.01	$582.20	$582.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $381.80 / $524.97 / $688.24	Professional		$381.80	$524.97	$688.24
United Facility/Professional Facility Modifier Low / Median / High Price $500.36 / $500.36 / $500.36	Facility		$500.36	$500.36	$500.36
United Facility/Professional Professional Modifier Low / Median / High Price $299.33 / $449.00 / $663.45	Professional		$299.33	$449.00	$663.45