Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,737.80 / $1,778.28	Facility		$977.24	$1,737.80	$1,778.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $977.24 / $1,584.89	Professional		$776.25	$977.24	$1,584.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,995.26 / $3,981.07	Facility		$1,862.09	$1,995.26	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,096.48 / $2,398.83	Professional		$851.14	$1,096.48	$2,398.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Professional		$1,548.82	$1,548.82	$1,548.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,412.54 / $2,238.72	Facility		$933.25	$1,412.54	$2,238.72
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 $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $1,174.90	Professional		$870.96	$870.96	$1,174.90
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $2,570.40	Facility		$1,174.90	$1,174.90	$2,570.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $1,174.90	Professional		$870.96	$870.96	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,122.02 / $1,621.81	Professional		$794.33	$1,122.02	$1,621.81
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility		$2,238.72	$2,238.72	$2,238.72
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,089.30 / $3,890.45	Professional		$1,862.09	$2,089.30	$3,890.45
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $977.24 / $2,089.30	Facility		$691.83	$977.24	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $891.25 / $1,348.96	Professional		$616.60	$891.25	$1,348.96