Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,174.90 / $1,621.81	Professional		$891.25	$1,174.90	$1,621.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,096.48 / $1,778.28	Professional		$851.14	$1,096.48	$1,778.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,230.27 / $1,412.54	Facility		$1,096.48	$1,230.27	$1,412.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,380.38	Professional		$1,202.26	$1,202.26	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,905.46 / $1,949.84	Facility		$1,023.29	$1,905.46	$1,949.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,348.96 / $2,398.83	Professional		$933.25	$1,348.96	$2,398.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility		$1,905.46	$1,905.46	$1,905.46
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,348.96 / $2,187.76	Professional		$933.25	$1,348.96	$2,187.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,412.54 / $2,691.53	Professional		$1,202.26	$1,412.54	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,023.29 / $1,778.28	Professional		$776.25	$1,023.29	$1,778.28