Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $3,715.35 / $5,495.41	Facility		$1,949.84	$3,715.35	$5,495.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,995.26 / $4,073.80	Professional		$1,621.81	$1,995.26	$4,073.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,570.40 / $4,466.84	Facility		$2,238.72	$2,570.40	$4,466.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,202.26 / $3,162.28	Professional		$977.24	$1,202.26	$3,162.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $2,818.38	Facility		$2,818.38	$2,818.38	$2,818.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Professional		$3,311.31	$3,311.31	$3,311.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $5,128.61	Facility		$1,584.89	$1,584.89	$5,128.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,862.09 / $4,365.16	Professional		$1,122.02	$1,862.09	$4,365.16
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,511.89 / $10,000.00	Facility		$1,621.81	$2,511.89	$10,000.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,380.38 / $4,365.16	Professional		$1,122.02	$1,380.38	$4,365.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $2,041.74 / $3,019.95	Professional		$60.26	$2,041.74	$3,019.95
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Facility		$2,951.21	$2,951.21	$2,951.21
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,019.95 / $5,623.41	Professional		$2,089.30	$3,019.95	$5,623.41
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,187.76 / $2,454.71	Facility		$891.25	$2,187.76	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,479.11 / $2,818.38	Professional		$1,023.29	$1,479.11	$2,818.38