Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,288.25 / $1,318.26	Facility		$741.31	$1,288.25	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $741.31 / $1,258.93	Professional		$562.34	$741.31	$1,258.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,479.11 / $3,019.95	Facility		$1,412.54	$1,479.11	$3,019.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $831.76 / $1,778.28	Professional		$691.83	$831.76	$1,778.28
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 $1,023.29 / $1,412.54 / $2,137.96	Professional		$1,023.29	$1,412.54	$2,137.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $851.14	Professional		$630.96	$630.96	$851.14
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $2,137.96	Facility		$851.14	$851.14	$2,137.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $851.14	Professional		$630.96	$630.96	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $831.76 / $1,202.26	Professional		$602.56	$831.76	$1,202.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Facility		$1,698.24	$1,698.24	$1,698.24
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,584.89 / $2,884.03	Professional		$1,412.54	$1,584.89	$2,884.03
United Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $758.58 / $1,584.89	Facility		$575.44	$758.58	$1,584.89
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $691.83 / $1,023.29	Professional		$457.09	$691.83	$1,023.29