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 $1,047.13 / $1,479.11 / $1,995.26	Professional		$1,047.13	$1,479.11	$1,995.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $389.05 / $2,344.23	Professional		$338.84	$389.05	$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 $2,238.72 / $2,238.72 / $2,511.89	Professional		$2,238.72	$2,238.72	$2,511.89
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,819.70 / $7,244.36	Facility		$1,258.93	$1,819.70	$7,244.36
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 $1,479.11 / $2,041.74 / $3,890.45	Professional		$1,479.11	$2,041.74	$3,890.45
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