Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $8,912.51 / $11,748.98	Facility		$1,288.25	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,230.27 / $2,454.71	Professional		$1,023.29	$1,230.27	$2,454.71
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 $851.14 / $1,071.52 / $1,778.28	Professional		$851.14	$1,071.52	$1,778.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,148.15 / $1,445.44	Facility		$1,122.02	$1,148.15	$1,445.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,380.38	Professional		$1,230.27	$1,230.27	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $602.56 / $1,995.26	Facility		$34.67	$602.56	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,445.44 / $2,570.40	Professional		$870.96	$1,445.44	$2,570.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,202.26 / $1,995.26	Facility		$524.81	$1,202.26	$1,995.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,412.54 / $2,344.23	Professional		$467.74	$1,412.54	$2,344.23
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 $1,148.15 / $1,348.96 / $2,570.40	Professional		$1,148.15	$1,348.96	$2,570.40
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 $891.25 / $1,230.27 / $1,995.26	Professional		$891.25	$1,230.27	$1,995.26