Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,445.44 / $2,089.30	Professional		$1,202.26	$1,445.44	$2,089.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,995.26 / $2,884.03	Professional		$1,380.38	$1,995.26	$2,884.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $199.53 / $269.15	Facility		$134.90	$199.53	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $239.88	Professional		$173.78	$173.78	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $2,630.27	Facility		$1,621.81	$1,621.81	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $2,951.21	Professional		$1,380.38	$1,380.38	$2,951.21
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $2,630.27	Facility		$1,621.81	$1,621.81	$2,630.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $1,380.38 / $1,621.81	Professional		$199.53	$1,380.38	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,318.26 / $2,089.30	Professional		$851.14	$1,318.26	$2,089.30
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,290.87 / $3,890.45	Professional		$1,949.84	$2,290.87	$3,890.45
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $912.01 / $1,698.24	Facility		$102.33	$912.01	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,023.29 / $1,621.81	Professional		$724.44	$1,023.29	$1,621.81