Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,047.13 / $1,445.44	Facility		$831.76	$1,047.13	$1,445.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $794.33 / $1,122.02	Professional		$602.56	$794.33	$1,122.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,659.59 / $3,388.44	Facility		$1,584.89	$1,659.59	$3,388.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $891.25 / $1,995.26	Professional		$758.58	$891.25	$1,995.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,148.15 / $1,819.70	Facility		$758.58	$1,148.15	$1,819.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,380.38 / $2,089.30	Professional		$1,000.00	$1,380.38	$2,089.30
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 $616.60 / $616.60 / $851.14	Professional		$616.60	$616.60	$851.14
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $2,089.30	Facility		$851.14	$851.14	$2,089.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $851.14	Professional		$616.60	$616.60	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $933.25 / $1,348.96	Professional		$676.08	$933.25	$1,348.96
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility		$1,862.09	$1,862.09	$1,862.09
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,737.80 / $3,235.94	Professional		$1,584.89	$1,737.80	$3,235.94
United Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $724.44 / $1,548.82	Facility		$562.34	$724.44	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $724.44 / $1,071.52	Professional		$512.86	$724.44	$1,071.52