Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,548.82 / $1,548.82	Facility		$870.96	$1,548.82	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $870.96 / $1,412.54	Professional		$660.69	$870.96	$1,412.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,737.80 / $3,548.13	Facility		$1,659.59	$1,737.80	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $2,137.96	Professional		$794.33	$1,000.00	$2,137.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,412.54 / $2,290.87	Facility		$954.99	$1,412.54	$2,290.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,698.24 / $2,570.40	Professional		$1,230.27	$1,698.24	$2,570.40
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 $758.58 / $758.58 / $1,023.29	Professional		$758.58	$758.58	$1,023.29
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $2,570.40	Facility		$1,023.29	$1,023.29	$2,570.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $1,023.29	Professional		$758.58	$758.58	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $446.68	Professional		$223.87	$316.23	$446.68
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,862.09 / $3,467.37	Professional		$1,659.59	$1,862.09	$3,467.37
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 $549.54 / $794.33 / $1,202.26	Professional		$549.54	$794.33	$1,202.26