Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,698.24 / $2,041.74	Facility		$1,148.15	$1,698.24	$2,041.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,122.02 / $1,698.24	Professional		$870.96	$1,122.02	$1,698.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,344.23 / $4,677.35	Facility		$2,187.76	$2,344.23	$4,677.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,258.93 / $2,818.38	Professional		$1,047.13	$1,258.93	$2,818.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,445.44 / $2,344.23	Facility		$977.24	$1,445.44	$2,344.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,737.80 / $2,630.27	Professional		$1,258.93	$1,737.80	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,412.54	Professional		$1,023.29	$1,023.29	$1,412.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $2,754.23	Facility		$1,412.54	$1,412.54	$2,754.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,412.54	Professional		$1,023.29	$1,023.29	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,318.26 / $1,905.46	Professional		$933.25	$1,318.26	$1,905.46
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility		$2,630.27	$2,630.27	$2,630.27
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,454.71 / $4,570.88	Professional		$2,187.76	$2,454.71	$4,570.88
United Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,071.52 / $2,238.72	Facility		$812.83	$1,071.52	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,023.29 / $1,479.11	Professional		$724.44	$1,023.29	$1,479.11