Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,621.81 / $1,737.80	Facility		$977.24	$1,621.81	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $933.25 / $1,412.54	Professional		$660.69	$933.25	$1,412.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,949.84 / $3,981.07	Facility		$1,862.09	$1,949.84	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,071.52 / $2,344.23	Professional		$891.25	$1,071.52	$2,344.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,202.26 / $1,905.46	Facility		$794.33	$1,202.26	$1,905.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,445.44 / $2,187.76	Professional		$1,047.13	$1,445.44	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $1,023.29	Professional		$741.31	$741.31	$1,023.29
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $2,187.76	Facility		$1,023.29	$1,023.29	$2,187.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $1,023.29	Professional		$741.31	$741.31	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,122.02 / $1,584.89	Professional		$794.33	$1,122.02	$1,584.89
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility		$2,238.72	$2,238.72	$2,238.72
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,089.30 / $3,801.89	Professional		$1,862.09	$2,089.30	$3,801.89
United Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $870.96 / $1,862.09	Facility		$616.60	$870.96	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $851.14 / $1,230.27	Professional		$602.56	$851.14	$1,230.27