Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $912.01 / $1,288.25	Professional		$758.58	$912.01	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,202.26 / $1,949.84	Professional		$1,148.15	$1,202.26	$1,949.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $144.54 / $1,621.81	Facility		$75.86	$144.54	$1,621.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $1,621.81	Professional		$97.72	$134.90	$1,621.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $1,071.52	Facility		$645.65	$645.65	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $1,737.80	Professional		$549.54	$549.54	$1,737.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $1,513.56	Facility		$645.65	$645.65	$1,513.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $645.65 / $1,513.56	Professional		$549.54	$645.65	$1,513.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $144.54	Professional		$109.65	$109.65	$144.54
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 $77.62 / $630.96 / $1,148.15	Facility		$77.62	$630.96	$1,148.15
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $758.58 / $1,202.26	Professional		$501.19	$758.58	$1,202.26