Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,659.59 / $2,754.23	Facility		$933.25	$1,659.59	$2,754.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $954.99 / $1,778.28	Professional		$776.25	$954.99	$1,778.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,230.27 / $2,137.96	Facility		$1,071.52	$1,230.27	$2,137.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $1,513.56	Professional		$467.74	$562.34	$1,513.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility		$1,348.96	$1,348.96	$1,348.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Professional		$1,548.82	$1,548.82	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $2,454.71	Facility		$758.58	$758.58	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,047.13 / $2,089.30	Professional		$562.34	$1,047.13	$2,089.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,202.26 / $4,786.30	Facility		$776.25	$1,202.26	$4,786.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $645.65 / $2,089.30	Professional		$562.34	$645.65	$2,089.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,047.13 / $1,445.44	Professional		$870.96	$1,047.13	$1,445.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,412.54 / $2,691.53	Professional		$977.24	$1,412.54	$2,691.53
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,047.13 / $1,148.15	Facility		$416.87	$1,047.13	$1,148.15
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $691.83 / $1,348.96	Professional		$489.78	$691.83	$1,348.96