Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,047.13 / $1,819.70	Facility		$891.25	$1,047.13	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,071.52 / $1,348.96	Professional		$891.25	$1,071.52	$1,348.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $489.78	Professional		$208.93	$281.84	$489.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $223.87 / $1,071.52	Facility		$186.21	$223.87	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $323.59 / $1,513.56	Facility		$251.19	$323.59	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,318.26 / $2,511.89	Professional		$912.01	$1,318.26	$2,511.89
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Facility		$1,479.11	$1,479.11	$1,479.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,288.25 / $2,454.71	Professional		$870.96	$1,288.25	$2,454.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $257.04	Professional		$32.36	$33.11	$257.04
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $75.86	Professional		$50.12	$60.26	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $2,041.74	Facility		$1,737.80	$1,737.80	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,737.80 / $3,311.31	Professional		$660.69	$1,737.80	$3,311.31