Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,884.03 / $4,677.35	Facility		$1,862.09	$2,884.03	$4,677.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,584.89 / $1,949.84	Professional		$1,258.93	$1,584.89	$1,949.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,041.74 / $3,548.13	Facility		$1,778.28	$2,041.74	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $407.38 / $2,344.23	Professional		$323.59	$407.38	$2,344.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $26,915.35 / $41,686.94	Facility		$1,819.70	$26,915.35	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $30,902.95 / $53,703.18	Professional		$2,398.83	$30,902.95	$53,703.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $3,715.35	Facility		$1,258.93	$1,258.93	$3,715.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,238.72 / $2,511.89	Professional		$1,548.82	$2,238.72	$2,511.89
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,995.26 / $7,244.36	Facility		$1,258.93	$1,995.26	$7,244.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Professional		$1,548.82	$1,548.82	$1,548.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,737.80 / $2,398.83	Professional		$1,479.11	$1,737.80	$2,398.83
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility		$2,344.23	$2,344.23	$2,344.23
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,137.96 / $4,570.88	Professional		$1,659.59	$2,137.96	$4,570.88
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,737.80 / $1,949.84	Facility		$707.95	$1,737.80	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,047.13 / $2,238.72	Professional		$741.31	$1,047.13	$2,238.72