Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $758.58 / $1,318.26	Facility		$354.81	$758.58	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $1,000.00	Professional		$354.81	$407.38	$1,000.00
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 $218.78 / $275.42 / $1,318.26	Professional		$218.78	$275.42	$1,318.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $1,513.56	Facility		$660.69	$660.69	$1,513.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Professional		$1,778.28	$1,778.28	$1,778.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $851.14 / $1,698.24	Facility		$295.12	$851.14	$1,698.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $398.11 / $1,513.56	Professional		$223.87	$398.11	$1,513.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $457.09 / $1,659.59	Facility		$295.12	$457.09	$1,659.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $1,348.96	Professional		$223.87	$288.40	$1,348.96
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 / $1,258.93 / $2,570.40	Professional		$851.14	$1,258.93	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $549.54 / $1,318.26	Facility		$302.00	$549.54	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $263.03 / $724.44	Professional		$186.21	$263.03	$724.44