Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $851.14 / $1,445.44	Facility		$575.44	$851.14	$1,445.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $489.78 / $645.65	Professional		$363.08	$489.78	$645.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $776.25	Professional		$112.20	$138.04	$776.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $8,511.38 / $41,686.94	Facility		$562.34	$8,511.38	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $9,549.93 / $16,982.44	Professional		$741.31	$9,549.93	$16,982.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $1,288.25	Facility		$398.11	$398.11	$1,288.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $776.25	Professional		$707.95	$707.95	$776.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $758.58 / $3,548.13	Facility		$398.11	$758.58	$3,548.13
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $645.65 / $1,202.26	Professional		$457.09	$645.65	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $549.54 / $602.56	Facility		$218.78	$549.54	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $363.08 / $691.83	Professional		$257.04	$363.08	$691.83