Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $9,120.11 / $11,748.98	Facility		$1,737.80	$9,120.11	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $3,981.07 / $11,748.98	Professional		$1,047.13	$3,981.07	$11,748.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $7,244.36 / $17,782.79	Facility		$707.95	$7,244.36	$17,782.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $0.03	Professional		$0.02	$0.02	$0.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60,255.96 / $72,443.60 / $79,432.82	Facility		$60,255.96	$72,443.60	$79,432.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75,857.76 / $75,857.76 / $79,432.82	Professional		$75,857.76	$75,857.76	$79,432.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $562.34 / $21,379.62	Facility		$34.67	$562.34	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Professional		$1,096.48	$1,096.48	$1,096.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $575.44 / $21,379.62	Facility		$426.58	$575.44	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Professional		$1,096.48	$1,096.48	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $60.26	Professional		$30.20	$50.12	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $870.96	Facility		$100.00	$100.00	$870.96
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $75.86	Professional		$50.12	$70.79	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $1,698.24 / $3,981.07	Facility		$489.78	$1,698.24	$3,981.07