Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,187.76 / $2,754.23	Professional		$1,659.59	$2,187.76	$2,754.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,344.23 / $4,786.30	Professional		$1,905.46	$2,344.23	$4,786.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $323.59 / $2,818.38	Facility		$158.49	$323.59	$2,818.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $3,388.44	Professional		$208.93	$288.40	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,398.83 / $2,398.83	Facility		$2,041.74	$2,398.83	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $3,981.07	Professional		$2,041.74	$2,041.74	$3,981.07
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,398.83 / $2,398.83	Facility		$2,041.74	$2,398.83	$2,398.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $2,041.74 / $2,398.83	Professional		$281.84	$2,041.74	$2,398.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $398.11 / $2,454.71	Professional		$144.54	$398.11	$2,454.71
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,818.38 / $4,677.35	Professional		$2,398.83	$2,818.38	$4,677.35
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $302.00 / $1,905.46	Facility		$138.04	$302.00	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,318.26 / $1,995.26	Professional		$776.25	$1,318.26	$1,995.26