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 $1,348.96 / $1,659.59 / $3,162.28	Professional		$1,348.96	$1,659.59	$3,162.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,309.57 / $15,135.61	Facility		$1,698.24	$6,309.57	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,513.56 / $2,511.89	Professional		$1,174.90	$1,513.56	$2,511.89
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 / $1,698.24 / $2,630.27	Facility		$34.67	$1,698.24	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,949.84 / $3,311.31	Professional		$1,202.26	$1,949.84	$3,311.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $2,630.27 / $2,630.27	Facility		$562.34	$2,630.27	$2,630.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,905.46 / $3,162.28	Professional		$660.69	$1,905.46	$3,162.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $208.93	Professional		$32.36	$33.11	$208.93
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 / $1,698.24 / $3,235.94	Professional		$1,479.11	$1,698.24	$3,235.94
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 $1,230.27 / $1,659.59 / $2,754.23	Professional		$1,230.27	$1,659.59	$2,754.23