Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $977.24 / $1,288.25	Professional		$776.25	$977.24	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $954.99 / $1,548.82	Professional		$645.65	$954.99	$1,548.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $173.78 / $1,230.27	Facility		$87.10	$173.78	$1,230.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $1,445.44	Professional		$114.82	$158.49	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,737.80	Professional		$1,230.27	$1,230.27	$1,737.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $1,230.27 / $1,230.27	Professional		$128.82	$1,230.27	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $218.78 / $1,318.26	Professional		$79.43	$218.78	$1,318.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,513.56 / $2,570.40	Professional		$1,288.25	$1,513.56	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $512.86 / $977.24	Facility		$72.44	$512.86	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $676.08 / $1,000.00	Professional		$446.68	$676.08	$1,000.00