Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,122.02 / $1,819.70	Facility		$707.95	$1,122.02	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $616.60 / $891.25	Professional		$524.81	$616.60	$891.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $10.72 / $1,202.26	Professional		$10.72	$10.72	$1,202.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $891.25	Facility		$870.96	$870.96	$891.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $11,748.98 / $20,892.96	Professional		$912.01	$11,748.98	$20,892.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $1,584.89	Facility		$489.78	$489.78	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $870.96 / $1,071.52	Professional		$489.78	$870.96	$1,071.52
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $776.25 / $1,584.89	Facility		$489.78	$776.25	$1,584.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $1,513.56	Professional		$616.60	$616.60	$1,513.56
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $794.33 / $1,479.11	Professional		$489.78	$794.33	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $489.78 / $758.58	Facility		$269.15	$489.78	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $446.68 / $758.58	Professional		$316.23	$446.68	$758.58