Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $812.83 / $1,071.52	Professional		$602.56	$812.83	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $776.25 / $1,288.25	Professional		$537.03	$776.25	$1,288.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $120.23 / $831.76	Facility		$60.26	$120.23	$831.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $1,000.00	Professional		$77.62	$109.65	$1,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,122.02	Facility		$1,000.00	$1,000.00	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $851.14 / $1,659.59	Professional		$851.14	$851.14	$1,659.59
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,122.02	Facility		$1,000.00	$1,000.00	$1,122.02
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,000.00 / $1,000.00	Professional		$851.14	$1,000.00	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $165.96 / $1,122.02	Professional		$67.61	$165.96	$1,122.02
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,288.25 / $2,137.96	Professional		$1,096.48	$1,288.25	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $416.87 / $794.33	Facility		$58.88	$416.87	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $549.54 / $812.83	Professional		$363.08	$549.54	$812.83