Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,698.24 / $2,041.74	Facility		$1,174.90	$1,698.24	$2,041.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,122.02 / $1,698.24	Professional		$870.96	$1,122.02	$1,698.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,344.23 / $4,786.30	Facility		$2,238.72	$2,344.23	$4,786.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,258.93 / $2,818.38	Professional		$1,071.52	$1,258.93	$2,818.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,621.81 / $2,630.27	Facility		$1,096.48	$1,621.81	$2,630.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,949.84 / $2,951.21	Professional		$1,412.54	$1,949.84	$2,951.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,412.54	Professional		$1,023.29	$1,023.29	$1,412.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $2,951.21	Facility		$1,412.54	$1,412.54	$2,951.21
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,412.54	Professional		$1,023.29	$1,023.29	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,862.09 / $2,691.53	Professional		$1,202.26	$1,862.09	$2,691.53
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Facility		$2,691.53	$2,691.53	$2,691.53
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,511.89 / $4,570.88	Professional		$2,238.72	$2,511.89	$4,570.88
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,047.13 / $2,238.72	Facility		$741.31	$1,047.13	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,023.29 / $1,479.11	Professional		$724.44	$1,023.29	$1,479.11