Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $2,290.87	Facility		$1,318.26	$1,862.09	$2,290.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,258.93 / $1,862.09	Professional		$954.99	$1,258.93	$1,862.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,630.27 / $5,370.32	Facility		$2,511.89	$2,630.27	$5,370.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,445.44 / $3,162.28	Professional		$1,202.26	$1,445.44	$3,162.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,698.24 / $2,754.23	Facility		$1,148.15	$1,698.24	$2,754.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,041.74 / $3,090.30	Professional		$1,479.11	$2,041.74	$3,090.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility		$1,513.56	$1,513.56	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,513.56	Professional		$1,096.48	$1,096.48	$1,513.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $3,090.30	Facility		$1,513.56	$1,513.56	$3,090.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,513.56	Professional		$1,096.48	$1,096.48	$1,513.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,479.11 / $2,137.96	Professional		$1,071.52	$1,479.11	$2,137.96
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility		$3,019.95	$3,019.95	$3,019.95
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,818.38 / $5,128.61	Professional		$2,511.89	$2,818.38	$5,128.61
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,258.93 / $2,630.27	Facility		$954.99	$1,258.93	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,148.15 / $1,737.80	Professional		$812.83	$1,148.15	$1,737.80