Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $8,912.51 / $12,302.69	Facility		$2,691.53	$8,912.51	$12,302.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,513.56 / $3,981.07	Professional		$1,230.27	$1,513.56	$3,981.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,456.54 / $15,135.61	Facility		$1,698.24	$6,456.54	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,412.54 / $2,238.72	Professional		$1,122.02	$1,412.54	$2,238.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,348.96 / $1,698.24	Facility		$1,318.26	$1,348.96	$1,698.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,621.81	Professional		$1,445.44	$1,445.44	$1,621.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $1,513.56 / $2,344.23	Facility		$34.67	$1,513.56	$2,344.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,778.28 / $3,019.95	Professional		$1,096.48	$1,778.28	$3,019.95
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,344.23 / $21,379.62	Facility		$426.58	$2,344.23	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,737.80 / $2,884.03	Professional		$660.69	$1,737.80	$2,884.03
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 $1,318.26 / $1,548.82 / $2,951.21	Professional		$1,318.26	$1,548.82	$2,951.21
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 $1,096.48 / $1,479.11 / $2,511.89	Professional		$1,096.48	$1,479.11	$2,511.89