Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,000.00 / $1,548.82	Facility		$912.01	$1,000.00	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $912.01 / $1,148.15	Professional		$794.33	$912.01	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $281.84 / $1,047.13	Professional		$218.78	$281.84	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $1,047.13	Facility		$891.25	$891.25	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility		$1,513.56	$1,513.56	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $2,630.27	Professional		$912.01	$1,230.27	$2,630.27
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility		$1,513.56	$1,513.56	$1,513.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,230.27 / $2,344.23	Professional		$891.25	$1,230.27	$2,344.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,412.54 / $1,819.70	Professional		$933.25	$1,412.54	$1,819.70
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,047.13 / $1,995.26	Professional		$891.25	$1,047.13	$1,995.26
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $891.25	Facility		$741.31	$741.31	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,148.15 / $1,995.26	Professional		$741.31	$1,148.15	$1,995.26