Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,949.84 / $2,344.23	Facility		$1,318.26	$1,949.84	$2,344.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,288.25 / $1,949.84	Professional		$977.24	$1,288.25	$1,949.84
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 / $3,235.94	Professional		$1,202.26	$1,445.44	$3,235.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,862.09 / $2,951.21	Facility		$1,230.27	$1,862.09	$2,951.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,238.72 / $3,388.44	Professional		$1,621.81	$2,238.72	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility		$1,621.81	$1,621.81	$1,621.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,621.81	Professional		$1,174.90	$1,174.90	$1,621.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $3,388.44	Facility		$1,621.81	$1,621.81	$3,388.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,621.81	Professional		$1,174.90	$1,174.90	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,621.81 / $2,344.23	Professional		$1,174.90	$1,621.81	$2,344.23
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 $851.14 / $1,202.26 / $2,570.40	Facility		$851.14	$1,202.26	$2,570.40
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,148.15 / $1,698.24	Professional		$812.83	$1,148.15	$1,698.24