Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $1,412.54	Facility		$933.25	$933.25	$1,412.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $891.25 / $1,258.93	Professional		$645.65	$891.25	$1,258.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,089.30 / $4,168.69	Facility		$1,949.84	$2,089.30	$4,168.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,122.02 / $2,511.89	Professional		$870.96	$1,122.02	$2,511.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,148.15 / $1,862.09	Facility		$758.58	$1,148.15	$1,862.09
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 $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $912.01	Professional		$660.69	$660.69	$912.01
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $912.01	Professional		$660.69	$660.69	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,174.90 / $1,698.24	Professional		$831.76	$1,174.90	$1,698.24
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility		$2,344.23	$2,344.23	$2,344.23
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,187.76 / $4,073.80	Professional		$1,949.84	$2,187.76	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,096.48 / $1,698.24	Facility		$630.96	$1,096.48	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $933.25 / $1,230.27	Professional		$602.56	$933.25	$1,230.27