Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $3,548.13 / $9,772.37	Facility		$1,047.13	$3,548.13	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $3,630.78 / $3,715.35	Professional		$3,548.13	$3,630.78	$3,715.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,949.84 / $12,589.25	Facility		$831.76	$1,949.84	$12,589.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $575.44 / $3,801.89	Professional		$446.68	$575.44	$3,801.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility		$2,511.89	$2,511.89	$2,511.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility		$3,890.45	$3,890.45	$3,890.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $3,890.45 / $4,570.88	Professional		$3,890.45	$3,890.45	$4,570.88
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $3,890.45 / $3,890.45	Facility		$1,412.54	$3,890.45	$3,890.45
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $3,890.45 / $4,570.88	Professional		$3,890.45	$3,890.45	$4,570.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $60.26	Professional		$32.36	$50.12	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $4,897.79 / $7,943.28	Professional		$3,981.07	$4,897.79	$7,943.28
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $776.25 / $776.25	Facility		$676.08	$776.25	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $3,630.78 / $3,801.89 / $4,168.69	Professional		$3,630.78	$3,801.89	$4,168.69