Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $8,912.51 / $11,748.98	Facility		$2,818.38	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,754.23 / $5,370.32	Professional		$2,290.87	$2,754.23	$5,370.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $9,549.93 / $21,379.62	Facility		$2,238.72	$9,549.93	$21,379.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,691.53 / $4,365.16	Professional		$2,137.96	$2,691.53	$4,365.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,511.89 / $3,162.28	Facility		$2,454.71	$2,511.89	$3,162.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $3,019.95	Professional		$2,691.53	$2,691.53	$3,019.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $2,951.21 / $4,365.16	Facility		$34.67	$2,951.21	$4,365.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,311.31 / $5,495.41	Professional		$1,995.26	$3,311.31	$5,495.41
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $4,365.16 / $21,379.62	Facility		$602.56	$4,365.16	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $3,235.94 / $5,248.07	Professional		$1,412.54	$3,235.94	$5,248.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,818.38 / $5,370.32	Professional		$2,398.83	$2,818.38	$5,370.32
United Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $2,691.53 / $6,760.83	Facility		$575.44	$2,691.53	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,818.38 / $4,570.88	Professional		$2,041.74	$2,818.38	$4,570.88