Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $977.24 / $1,288.25	Professional		$831.76	$977.24	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $812.83 / $1,621.81	Professional		$676.08	$812.83	$1,621.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $144.54 / $1,000.00	Facility		$72.44	$144.54	$1,000.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $1,202.26	Professional		$93.33	$128.82	$1,202.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,047.13 / $1,047.13	Facility		$575.44	$1,047.13	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $1,659.59	Professional		$891.25	$891.25	$1,659.59
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,047.13 / $1,047.13	Facility		$575.44	$1,047.13	$1,047.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $891.25 / $1,047.13	Professional		$125.89	$891.25	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $208.93 / $1,412.54	Professional		$85.11	$208.93	$1,412.54
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,584.89 / $2,691.53	Professional		$1,348.96	$1,584.89	$2,691.53
United Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $501.19 / $954.99	Facility		$70.79	$501.19	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $660.69 / $977.24	Professional		$436.52	$660.69	$977.24