Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $8,912.51 / $11,748.98	Facility		$691.83	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $660.69 / $1,258.93	Professional		$549.54	$660.69	$1,258.93
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 $575.44 / $741.31 / $1,230.27	Professional		$575.44	$741.31	$1,230.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $602.56 / $758.58	Facility		$588.84	$602.56	$758.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $724.44	Professional		$645.65	$645.65	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $602.56 / $1,202.26	Facility		$34.67	$602.56	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $794.33 / $1,348.96	Professional		$512.86	$794.33	$1,348.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,047.13 / $1,202.26	Facility		$524.81	$1,047.13	$1,202.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $776.25 / $1,258.93	Professional		$501.19	$776.25	$1,258.93
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 $602.56 / $707.95 / $1,348.96	Professional		$602.56	$707.95	$1,348.96
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 $489.78 / $660.69 / $1,096.48	Professional		$489.78	$660.69	$1,096.48