Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,096.48 / $1,737.80	Facility		$630.96	$1,096.48	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $741.31 / $1,096.48	Professional		$630.96	$741.31	$1,096.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $831.76 / $1,445.44	Facility		$707.95	$831.76	$1,445.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $398.11 / $1,096.48	Professional		$309.03	$398.11	$1,096.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $891.25 / $1,096.48	Facility		$630.96	$891.25	$1,096.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $1,047.13	Professional		$776.25	$776.25	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $2,691.53	Facility		$512.86	$512.86	$2,691.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $676.08 / $1,548.82	Professional		$354.81	$676.08	$1,548.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $794.33 / $2,691.53	Facility		$524.81	$794.33	$2,691.53
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $1,737.80	Professional		$354.81	$407.38	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $707.95 / $954.99	Professional		$588.84	$707.95	$954.99
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $851.14 / $1,819.70	Professional		$660.69	$851.14	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $707.95 / $776.25	Facility		$281.84	$707.95	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $891.25	Professional		$331.13	$467.74	$891.25