Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $819.65 / $819.65 / $1,813.00	Facility		$819.65	$819.65	$1,813.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $796.76 / $819.65 / $1,115.09	Professional		$796.76	$819.65	$1,115.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,326.13 / $1,326.13 / $1,326.13	Professional		$1,326.13	$1,326.13	$1,326.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,576.24 / $1,846.50 / $4,784.12	Facility		$1,576.24	$1,846.50	$4,784.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $841.00 / $888.37 / $2,182.23	Professional		$841.00	$888.37	$2,182.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,218.64 / $1,678.64 / $2,266.16	Facility		$1,218.64	$1,678.64	$2,266.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,091.11 / $1,510.78 / $3,594.30	Professional		$1,091.11	$1,510.78	$3,594.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.63 / $908.63 / $1,912.51	Facility		$908.63	$908.63	$1,912.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.30 / $663.30 / $1,160.77	Professional		$663.30	$663.30	$1,160.77
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $908.63 / $908.63 / $908.63	Facility		$908.63	$908.63	$908.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $663.30 / $908.63 / $908.63	Professional		$663.30	$908.63	$908.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $636.71 / $875.47 / $1,147.75	Professional		$636.71	$875.47	$1,147.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,648.02 / $1,648.02 / $1,938.85	Facility		$1,648.02	$1,648.02	$1,938.85
United Facility/Professional Professional Modifier Low / Median / High Price $558.29 / $837.46 / $1,117.90	Professional		$558.29	$837.46	$1,117.90