Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,412.54 / $2,290.87	Facility		$891.25	$1,412.54	$2,290.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $776.25 / $1,148.15	Professional		$575.44	$776.25	$1,148.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,000.00 / $1,737.80	Facility		$870.96	$1,000.00	$1,737.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $1,174.90	Professional		$134.90	$177.83	$1,174.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $13,182.57 / $41,686.94	Facility		$891.25	$13,182.57	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $14,791.08 / $26,302.68	Professional		$1,174.90	$14,791.08	$26,302.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $3,235.94	Facility		$616.60	$616.60	$3,235.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,096.48 / $1,202.26	Professional		$549.54	$1,096.48	$1,202.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $977.24 / $3,890.45	Facility		$630.96	$977.24	$3,890.45
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
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 $812.83 / $1,047.13 / $2,187.76	Professional		$812.83	$1,047.13	$2,187.76
United Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $851.14 / $954.99	Facility		$338.84	$851.14	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $1,096.48	Professional		$398.11	$575.44	$1,096.48