Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $6,456.54 / $10,964.78	Facility		$1,862.09	$6,456.54	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $3,715.35	Professional		$1,148.15	$1,380.38	$3,715.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $10,715.19 / $24,547.09	Facility		$2,570.40	$10,715.19	$24,547.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $2,137.96	Professional		$1,047.13	$1,318.26	$2,137.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,258.93 / $1,584.89	Facility		$1,230.27	$1,258.93	$1,584.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,513.56	Professional		$1,348.96	$1,348.96	$1,513.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $1,202.26 / $2,187.76	Facility		$34.67	$1,202.26	$2,187.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,659.59 / $2,818.38	Professional		$1,023.29	$1,659.59	$2,818.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,202.26 / $2,187.76	Facility		$524.81	$1,202.26	$2,187.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,621.81 / $2,630.27	Professional		$933.25	$1,621.81	$2,630.27
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 Professional Modifier Low / Median / High Price $1,230.27 / $1,445.44 / $2,754.23	Professional		$1,230.27	$1,445.44	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $5,128.61 / $9,332.54	Facility		$933.25	$5,128.61	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,412.54 / $2,290.87	Professional		$1,023.29	$1,412.54	$2,290.87