Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $8,912.51 / $11,748.98	Facility		$2,041.74	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,995.26 / $3,890.45	Professional		$1,659.59	$1,995.26	$3,890.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,128.61 / $14,791.08	Facility		$1,698.24	$5,128.61	$14,791.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,949.84 / $3,162.28	Professional		$1,548.82	$1,949.84	$3,162.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,819.70 / $2,238.72	Facility		$1,698.24	$1,819.70	$2,238.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $2,137.96	Professional		$1,905.46	$1,905.46	$2,137.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $2,137.96 / $3,090.30	Facility		$34.67	$2,137.96	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,398.83 / $3,981.07	Professional		$1,348.96	$2,398.83	$3,981.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $3,090.30 / $21,379.62	Facility		$426.58	$3,090.30	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $2,290.87 / $3,801.89	Professional		$660.69	$2,290.87	$3,801.89
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 $1,698.24 / $1,995.26 / $3,715.35	Professional		$1,698.24	$1,995.26	$3,715.35
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 $1,479.11 / $2,041.74 / $3,311.31	Professional		$1,479.11	$2,041.74	$3,311.31