Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $1,584.89	Facility		$870.96	$870.96	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $870.96 / $1,380.38	Professional		$691.83	$870.96	$1,380.38
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 $891.25 / $1,071.52 / $2,290.87	Professional		$891.25	$1,071.52	$2,290.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,230.27 / $1,949.84	Facility		$812.83	$1,230.27	$1,949.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,479.11 / $2,187.76	Professional		$1,071.52	$1,479.11	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $1,023.29	Professional		$741.31	$741.31	$1,023.29
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $1,023.29	Professional		$741.31	$741.31	$1,023.29
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 $741.31 / $1,230.27 / $1,905.46	Facility		$741.31	$1,230.27	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $870.96 / $1,258.93	Professional		$588.84	$870.96	$1,258.93