Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,570.40 / $4,168.69	Facility		$1,659.59	$2,570.40	$4,168.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,445.44 / $1,995.26	Professional		$1,047.13	$1,445.44	$1,995.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $512.86 / $1,905.46	Professional		$426.58	$512.86	$1,905.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $24,547.09 / $41,686.94	Facility		$1,621.81	$24,547.09	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $27,542.29 / $48,977.88	Professional		$2,137.96	$27,542.29	$48,977.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $2,290.87	Facility		$1,148.15	$1,148.15	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,238.72	Professional		$2,041.74	$2,041.74	$2,238.72
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,995.26 / $10,232.93	Facility		$1,148.15	$1,995.26	$10,232.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $3,467.37	Professional		$1,318.26	$1,862.09	$3,467.37
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,584.89 / $1,737.80	Facility		$630.96	$1,584.89	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,047.13 / $1,995.26	Professional		$741.31	$1,047.13	$1,995.26