Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $3,311.31 / $7,079.46	Facility		$707.95	$3,311.31	$7,079.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $2,398.83 / $3,981.07	Professional		$724.44	$2,398.83	$3,981.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,090.30 / $5,370.32	Facility		$2,691.53	$3,090.30	$5,370.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,412.54 / $3,311.31	Professional		$1,174.90	$1,412.54	$3,311.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,235.94 / $3,981.07	Facility		$2,344.23	$3,235.94	$3,981.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,951.21 / $3,981.07	Professional		$1,905.46	$2,951.21	$3,981.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $10,000.00	Facility		$1,905.46	$1,905.46	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,570.40 / $5,888.44	Professional		$1,348.96	$2,570.40	$5,888.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,019.95 / $10,000.00	Facility		$1,905.46	$3,019.95	$10,000.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,698.24 / $5,888.44	Professional		$1,348.96	$1,698.24	$5,888.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,511.89 / $3,630.78	Professional		$1,949.84	$2,511.89	$3,630.78
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Facility		$3,467.37	$3,467.37	$3,467.37
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $3,090.30 / $6,760.83	Professional		$1,905.46	$3,090.30	$6,760.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,778.28 / $2,951.21	Facility		$1,047.13	$1,778.28	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,737.80 / $2,951.21	Professional		$1,230.27	$1,737.80	$2,951.21