Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $8,912.51 / $11,748.98	Facility		$2,454.71	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,344.23 / $4,786.30	Professional		$1,905.46	$2,344.23	$4,786.30
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 $1,513.56 / $1,995.26 / $3,311.31	Professional		$1,513.56	$1,995.26	$3,311.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,137.96 / $2,691.53	Facility		$2,089.30	$2,137.96	$2,691.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,570.40	Professional		$2,290.87	$2,290.87	$2,570.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $602.56 / $3,715.35	Facility		$34.67	$602.56	$3,715.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,754.23 / $4,786.30	Professional		$1,621.81	$2,754.23	$4,786.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,202.26 / $3,715.35	Facility		$524.81	$1,202.26	$3,715.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $2,630.27 / $4,466.84	Professional		$660.69	$2,630.27	$4,466.84
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 $2,137.96 / $2,454.71 / $4,677.35	Professional		$2,137.96	$2,454.71	$4,677.35
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 $1,698.24 / $2,290.87 / $3,890.45	Professional		$1,698.24	$2,290.87	$3,890.45