Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,380.38 / $1,698.24	Facility		$954.99	$1,380.38	$1,698.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $870.96 / $1,230.27	Professional		$630.96	$870.96	$1,230.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,905.46 / $3,890.45	Facility		$1,819.70	$1,905.46	$3,890.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,000.00 / $2,290.87	Professional		$851.14	$1,000.00	$2,290.87
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional		$1,513.56	$1,513.56	$1,513.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,288.25 / $2,089.30	Facility		$870.96	$1,288.25	$2,089.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,548.82 / $2,344.23	Professional		$1,122.02	$1,548.82	$2,344.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $891.25	Professional		$645.65	$645.65	$891.25
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $2,344.23	Facility		$891.25	$891.25	$2,344.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $891.25	Professional		$645.65	$645.65	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,071.52 / $1,548.82	Professional		$776.25	$1,071.52	$1,548.82
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility		$2,187.76	$2,187.76	$2,187.76
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,041.74 / $3,715.35	Professional		$1,819.70	$2,041.74	$3,715.35
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $776.25 / $1,659.59	Facility		$588.84	$776.25	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $794.33 / $1,122.02	Professional		$537.03	$794.33	$1,122.02