Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $831.76	Facility		$457.09	$457.09	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $501.19 / $794.33	Professional		$416.87	$501.19	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $691.83 / $954.99	Professional		$660.69	$691.83	$954.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,000.00 / $2,041.74	Facility		$954.99	$1,000.00	$2,041.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $588.84 / $1,230.27	Professional		$457.09	$588.84	$1,230.27
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $707.95 / $1,122.02	Facility		$467.74	$707.95	$1,122.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $1,258.93	Professional		$616.60	$851.14	$1,258.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Facility		$588.84	$588.84	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $588.84	Professional		$426.58	$426.58	$588.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Facility		$588.84	$588.84	$588.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $630.96	Professional		$426.58	$426.58	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $575.44 / $812.83	Professional		$407.38	$575.44	$812.83
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Facility		$1,148.15	$1,148.15	$1,148.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,071.52 / $1,949.84	Professional		$954.99	$1,071.52	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $707.95 / $1,071.52	Facility		$389.05	$707.95	$1,071.52
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $467.74 / $724.44	Professional		$309.03	$467.74	$724.44