Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,288.25 / $2,570.40	Facility		$758.58	$1,288.25	$2,570.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $758.58 / $1,258.93	Professional		$588.84	$758.58	$1,258.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,513.56 / $3,090.30	Facility		$1,445.44	$1,513.56	$3,090.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $851.14 / $1,819.70	Professional		$660.69	$851.14	$1,819.70
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,230.27	Professional		$1,202.26	$1,202.26	$1,230.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,071.52 / $1,737.80	Facility		$724.44	$1,071.52	$1,737.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,288.25 / $1,949.84	Professional		$933.25	$1,288.25	$1,949.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $831.76	Professional		$616.60	$616.60	$831.76
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $1,949.84	Facility		$831.76	$831.76	$1,949.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $831.76	Professional		$616.60	$616.60	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,096.48 / $1,584.89	Professional		$776.25	$1,096.48	$1,584.89
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,621.81 / $2,951.21	Professional		$1,445.44	$1,621.81	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $676.08 / $1,445.44	Facility		$524.81	$676.08	$1,445.44
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $660.69 / $954.99	Professional		$467.74	$660.69	$954.99