Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $8,912.51 / $11,748.98	Facility		$1,737.80	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,659.59 / $3,162.28	Professional		$1,412.54	$1,659.59	$3,162.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $4,570.88 / $21,877.62	Facility		$1,412.54	$4,570.88	$21,877.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,905.46 / $3,090.30	Professional		$1,513.56	$1,905.46	$3,090.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,479.11 / $1,905.46	Facility		$1,445.44	$1,479.11	$1,905.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,819.70	Professional		$1,621.81	$1,621.81	$1,819.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $602.56 / $2,630.27	Facility		$34.67	$602.56	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,089.30 / $3,548.13	Professional		$1,230.27	$2,089.30	$3,548.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,202.26 / $2,630.27	Facility		$524.81	$1,202.26	$2,630.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $2,041.74 / $3,311.31	Professional		$1,047.13	$2,041.74	$3,311.31
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 $1,479.11 / $1,737.80 / $3,311.31	Professional		$1,479.11	$1,737.80	$3,311.31
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 $1,288.25 / $1,819.70 / $2,951.21	Professional		$1,288.25	$1,819.70	$2,951.21