Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $630.96	Facility		$346.74	$346.74	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $354.81 / $575.44	Professional		$302.00	$354.81	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $758.58 / $1,548.82	Facility		$724.44	$758.58	$1,548.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $426.58 / $912.01	Professional		$346.74	$426.58	$912.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $501.19 / $812.83	Facility		$338.84	$501.19	$812.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $602.56 / $912.01	Professional		$436.52	$602.56	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $416.87	Professional		$309.03	$309.03	$416.87
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $416.87	Professional		$309.03	$309.03	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $436.52 / $616.60	Professional		$309.03	$436.52	$616.60
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Facility		$870.96	$870.96	$870.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $812.83 / $1,479.11	Professional		$724.44	$812.83	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $501.19 / $776.25	Facility		$302.00	$501.19	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $354.81 / $512.86	Professional		$234.42	$354.81	$512.86