Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.20 / $457.20 / $970.00	Facility		$457.20	$457.20	$970.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.93 / $457.20 / $579.42	Professional		$374.93	$457.20	$579.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $702.26 / $702.26 / $739.72	Professional		$702.26	$702.26	$739.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $879.23 / $1,029.99 / $2,668.60	Facility		$879.23	$1,029.99	$2,668.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $456.77 / $462.16 / $1,217.25	Professional		$456.77	$462.16	$1,217.25
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $795.90 / $795.90 / $795.90	Professional		$795.90	$795.90	$795.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $608.63 / $936.35 / $1,264.07	Facility		$608.63	$936.35	$1,264.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $608.63 / $842.72 / $2,004.91	Professional		$608.63	$842.72	$2,004.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $663.31 / $663.31 / $987.23	Facility		$663.31	$663.31	$987.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $484.22 / $484.22 / $778.55	Professional		$484.22	$484.22	$778.55
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $663.31 / $663.31 / $663.31	Facility		$663.31	$663.31	$663.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $484.22 / $663.31 / $663.31	Professional		$484.22	$663.31	$663.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $506.21 / $696.04 / $912.51	Professional		$506.21	$696.04	$912.51
United Facility/Professional Professional Modifier Low / Median / High Price $311.42 / $467.13 / $594.36	Professional		$311.42	$467.13	$594.36