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 $660.69 / $776.25 / $1,202.26	Professional		$660.69	$776.25	$1,202.26
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 $323.59 / $389.05 / $1,000.00	Professional		$323.59	$389.05	$1,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $1,096.48	Facility		$660.69	$660.69	$1,096.48
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 / $1,995.26	Facility		$616.60	$616.60	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,096.48 / $1,348.96	Professional		$616.60	$1,096.48	$1,348.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $977.24 / $1,995.26	Facility		$616.60	$977.24	$1,995.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
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 $616.60 / $1,000.00 / $1,905.46	Professional		$616.60	$1,000.00	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $616.60 / $954.99	Facility		$338.84	$616.60	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $954.99	Professional		$398.11	$575.44	$954.99