Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $371.54	Professional		$218.78	$309.03	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $489.78 / $794.33	Professional		$331.13	$489.78	$794.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $4,570.88 / $41,686.94	Facility		$302.00	$4,570.88	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $5,128.61 / $8,912.51	Professional		$398.11	$5,128.61	$8,912.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $1,513.56	Professional		$245.47	$302.00	$1,513.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $1,513.56	Professional		$245.47	$302.00	$1,513.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $75.86	Professional		$50.12	$70.79	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $398.11 / $891.25	Facility		$363.08	$398.11	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $630.96	Professional		$281.84	$363.08	$630.96