Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $724.44 / $870.96	Facility		$501.19	$724.44	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $724.44	Professional		$371.54	$478.63	$724.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,000.00 / $1,995.26	Facility		$933.25	$1,000.00	$1,995.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $537.03 / $1,230.27	Professional		$446.68	$537.03	$1,230.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $691.83 / $1,122.02	Facility		$467.74	$691.83	$1,122.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $831.76 / $1,258.93	Professional		$602.56	$831.76	$1,258.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $575.44	Professional		$416.87	$416.87	$575.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $1,258.93	Facility		$575.44	$575.44	$1,258.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $575.44	Professional		$416.87	$416.87	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $794.33 / $1,148.15	Professional		$501.19	$794.33	$1,148.15
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,047.13 / $1,949.84	Professional		$933.25	$1,047.13	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $446.68 / $954.99	Facility		$316.23	$446.68	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $436.52 / $630.96	Professional		$309.03	$436.52	$630.96