Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $691.83 / $912.01	Facility		$524.81	$691.83	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $489.78 / $691.83	Professional		$371.54	$489.78	$691.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,047.13 / $2,137.96	Facility		$1,000.00	$1,047.13	$2,137.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $549.54 / $1,258.93	Professional		$478.63	$549.54	$1,258.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $707.95 / $1,148.15	Facility		$478.63	$707.95	$1,148.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $1,288.25	Professional		$616.60	$851.14	$1,288.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $512.86	Professional		$371.54	$371.54	$512.86
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $1,288.25	Facility		$512.86	$512.86	$1,288.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $512.86	Professional		$371.54	$371.54	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $588.84 / $851.14	Professional		$426.58	$588.84	$851.14
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,122.02 / $2,041.74	Professional		$1,000.00	$1,122.02	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $457.09 / $954.99	Facility		$338.84	$457.09	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $446.68 / $630.96	Professional		$309.03	$446.68	$630.96