Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,174.90 / $1,621.81	Facility		$537.03	$1,174.90	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $676.08 / $1,148.15	Professional		$478.63	$676.08	$1,148.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,380.38 / $2,398.83	Facility		$1,202.26	$1,380.38	$2,398.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $426.58 / $1,380.38	Professional		$338.84	$426.58	$1,380.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,445.44 / $1,778.28	Facility		$1,047.13	$1,445.44	$1,778.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,318.26 / $1,778.28	Professional		$851.14	$1,318.26	$1,778.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $851.14 / $2,570.40	Facility		$457.09	$851.14	$2,570.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $616.60 / $1,698.24	Professional		$346.74	$616.60	$1,698.24
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $707.95 / $2,570.40	Facility		$457.09	$707.95	$2,570.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $436.52 / $1,698.24	Professional		$53.70	$436.52	$1,698.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,122.02 / $1,621.81	Professional		$870.96	$1,122.02	$1,621.81
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility		$1,548.82	$1,548.82	$1,548.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,380.38 / $2,570.40	Professional		$851.14	$1,380.38	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $549.54 / $1,318.26	Facility		$467.74	$549.54	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $933.25	Professional		$288.40	$407.38	$933.25