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 $1,698.24 / $2,041.74 / $3,890.45	Professional		$1,698.24	$2,041.74	$3,890.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,248.07 / $14,791.08	Facility		$1,698.24	$5,248.07	$14,791.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,995.26 / $3,235.94	Professional		$1,584.89	$1,995.26	$3,235.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,862.09 / $2,290.87	Facility		$1,737.80	$1,862.09	$2,290.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,187.76	Professional		$1,949.84	$1,949.84	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $2,187.76 / $3,162.28	Facility		$34.67	$2,187.76	$3,162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,454.71 / $4,073.80	Professional		$1,380.38	$2,454.71	$4,073.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $3,162.28 / $21,379.62	Facility		$426.58	$3,162.28	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $2,344.23 / $3,801.89	Professional		$660.69	$2,344.23	$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 $1,737.80 / $2,041.74 / $3,890.45	Professional		$1,737.80	$2,041.74	$3,890.45
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 $1,513.56 / $2,041.74 / $3,311.31	Professional		$1,513.56	$2,041.74	$3,311.31