Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,621.81 / $2,187.76	Facility		$1,258.93	$1,621.81	$2,187.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,071.52 / $1,621.81	Professional		$758.58	$1,071.52	$1,621.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,511.89 / $5,128.61	Facility		$2,398.83	$2,511.89	$5,128.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,348.96 / $3,019.95	Professional		$1,071.52	$1,348.96	$3,019.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,445.44 / $2,290.87	Facility		$954.99	$1,445.44	$2,290.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,737.80 / $2,630.27	Professional		$1,258.93	$1,737.80	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $1,096.48	Professional		$812.83	$812.83	$1,096.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $2,630.27	Facility		$1,096.48	$1,096.48	$2,630.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $1,096.48	Professional		$812.83	$812.83	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,412.54 / $2,041.74	Professional		$1,023.29	$1,412.54	$2,041.74
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $2,818.38	Facility		$2,818.38	$2,818.38	$2,818.38
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,630.27 / $4,897.79	Professional		$2,398.83	$2,630.27	$4,897.79
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $977.24 / $2,041.74	Facility		$741.31	$977.24	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,047.13 / $1,479.11	Professional		$660.69	$1,047.13	$1,479.11