Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $8,912.51 / $11,748.98	Facility		$1,513.56	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,445.44 / $2,818.38	Professional		$1,202.26	$1,445.44	$2,818.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $9,332.54 / $21,379.62	Facility		$2,238.72	$9,332.54	$21,379.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,380.38 / $2,238.72	Professional		$1,096.48	$1,380.38	$2,238.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,659.59	Facility		$1,288.25	$1,288.25	$1,659.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,584.89	Professional		$1,412.54	$1,412.54	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $1,479.11 / $2,290.87	Facility		$34.67	$1,479.11	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,698.24 / $2,884.03	Professional		$1,047.13	$1,698.24	$2,884.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,290.87 / $21,379.62	Facility		$426.58	$2,290.87	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,698.24 / $2,754.23	Professional		$660.69	$1,698.24	$2,754.23
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 $1,288.25 / $1,513.56 / $2,884.03	Professional		$1,288.25	$1,513.56	$2,884.03
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 $1,071.52 / $1,445.44 / $2,398.83	Professional		$1,071.52	$1,445.44	$2,398.83