Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $7,585.78 / $12,022.64	Facility		$2,089.30	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,479.11 / $6,165.95	Professional		$1,122.02	$1,479.11	$6,165.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,715.35 / $15,135.61	Facility		$1,698.24	$3,715.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,230.27 / $2,187.76	Professional		$1,000.00	$1,230.27	$2,187.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $2,511.89	Facility		$1,584.89	$1,584.89	$2,511.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,089.30 / $21,379.62	Facility		$1,862.09	$2,089.30	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,584.89 / $2,691.53	Professional		$1,047.13	$1,584.89	$2,691.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,089.30 / $21,379.62	Facility		$1,862.09	$2,089.30	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,584.89 / $2,818.38	Professional		$1,071.52	$1,584.89	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,290.87 / $4,786.30	Facility		$100.00	$2,290.87	$4,786.30
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,380.38 / $2,691.53	Professional		$1,174.90	$1,380.38	$2,691.53
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $5,754.40 / $9,120.11	Facility		$2,137.96	$5,754.40	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,318.26 / $2,290.87	Professional		$1,023.29	$1,318.26	$2,290.87