Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,230.27 / $1,513.56	Facility		$851.14	$1,230.27	$1,513.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $831.76 / $1,230.27	Professional		$630.96	$831.76	$1,230.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,698.24 / $3,467.37	Facility		$1,621.81	$1,698.24	$3,467.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $954.99 / $2,041.74	Professional		$776.25	$954.99	$2,041.74
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 / $2,137.96	Professional		$1,047.13	$1,445.44	$2,137.96
Cigna 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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $1,122.02	Professional		$812.83	$812.83	$1,122.02
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $2,187.76	Facility		$1,122.02	$1,122.02	$2,187.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $1,047.13	Professional		$812.83	$812.83	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,380.38 / $1,995.26	Professional		$870.96	$1,380.38	$1,995.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility		$1,949.84	$1,949.84	$1,949.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,819.70 / $3,311.31	Professional		$1,621.81	$1,819.70	$3,311.31
United Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $758.58 / $1,659.59	Facility		$549.54	$758.58	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $758.58 / $1,071.52	Professional		$524.81	$758.58	$1,071.52