Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $663.63 / $1,164.00	Facility		$663.63	$663.63	$1,164.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $683.53	Professional		$663.63	$663.63	$683.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $717.78 / $717.78 / $717.78	Professional		$717.78	$717.78	$717.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $769.81 / $1,324.27	Professional		$663.63	$769.81	$1,324.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $663.63 / $1,002.08	Facility		$663.63	$663.63	$1,002.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $895.90	Professional		$663.63	$663.63	$895.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $626.05 / $626.05 / $663.63	Facility		$626.05	$626.05	$663.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $939.09	Professional		$663.63	$663.63	$939.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $850.00 / $850.00 / $850.00	Facility		$850.00	$850.00	$850.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $1,000.00	Professional		$663.63	$663.63	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $791.30	Professional		$40.00	$50.00	$791.30
United Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $853.43	Professional		$663.63	$663.63	$853.43