Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,819.70 / $2,454.71	Professional		$1,548.82	$1,819.70	$2,454.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,041.74 / $3,162.28	Professional		$1,318.26	$2,041.74	$3,162.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $309.03 / $3,801.89	Facility		$154.88	$309.03	$3,801.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $3,801.89	Professional		$199.53	$275.42	$3,801.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $3,090.30	Facility		$1,412.54	$1,412.54	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $3,090.30	Professional		$1,202.26	$1,202.26	$3,090.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $3,090.30	Facility		$1,412.54	$1,412.54	$3,090.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $1,202.26 / $1,412.54	Professional		$165.96	$1,202.26	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $457.09 / $2,754.23	Professional		$165.96	$457.09	$2,754.23
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,162.28 / $5,248.07	Professional		$2,691.53	$3,162.28	$5,248.07
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $1,047.13 / $1,949.84	Facility		$128.82	$1,047.13	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,288.25 / $1,995.26	Professional		$851.14	$1,288.25	$1,995.26