Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $933.25 / $1,318.26	Facility		$741.31	$933.25	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $691.83 / $954.99	Professional		$549.54	$691.83	$954.99
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 $676.08 / $812.83 / $1,778.28	Professional		$676.08	$812.83	$1,778.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $912.01 / $1,445.44	Facility		$602.56	$912.01	$1,445.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,071.52 / $1,621.81	Professional		$776.25	$1,071.52	$1,621.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $758.58	Professional		$549.54	$549.54	$758.58
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,621.81	Facility		$758.58	$758.58	$1,621.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $758.58	Professional		$549.54	$549.54	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $851.14 / $1,202.26	Professional		$602.56	$851.14	$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 $501.19 / $645.65 / $1,380.38	Facility		$501.19	$645.65	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $645.65 / $933.25	Professional		$457.09	$645.65	$933.25