Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,000.00 / $1,737.80	Facility		$676.08	$1,000.00	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $588.84 / $831.76	Professional		$489.78	$588.84	$831.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $1,148.15	Professional		$229.09	$229.09	$1,148.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $831.76	Facility		$724.44	$724.44	$831.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $11,220.18 / $19,952.62	Professional		$891.25	$11,220.18	$19,952.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $1,513.56	Facility		$467.74	$467.74	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $831.76 / $1,023.29	Professional		$467.74	$831.76	$1,023.29
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $741.31 / $1,513.56	Facility		$467.74	$741.31	$1,513.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional		$1,513.56	$1,513.56	$1,513.56
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Facility		$870.96	$870.96	$870.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $758.58 / $1,445.44	Professional		$467.74	$758.58	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $467.74 / $724.44	Facility		$257.04	$467.74	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $436.52 / $724.44	Professional		$302.00	$436.52	$724.44