Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $2,041.74	Facility		$1,202.26	$1,202.26	$2,041.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,230.27 / $1,819.70	Professional		$891.25	$1,230.27	$1,819.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,691.53 / $5,370.32	Facility		$2,511.89	$2,691.53	$5,370.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,479.11 / $3,235.94	Professional		$1,230.27	$1,479.11	$3,235.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,548.82 / $2,511.89	Facility		$1,047.13	$1,548.82	$2,511.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,862.09 / $2,818.38	Professional		$1,348.96	$1,862.09	$2,818.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility		$1,621.81	$1,621.81	$1,621.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,621.81	Professional		$1,174.90	$1,174.90	$1,621.81
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility		$1,621.81	$1,621.81	$1,621.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,584.89	Professional		$1,174.90	$1,174.90	$1,584.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,041.74 / $3,019.95	Professional		$1,318.26	$2,041.74	$3,019.95
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility		$3,019.95	$3,019.95	$3,019.95
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,818.38 / $5,248.07	Professional		$2,511.89	$2,818.38	$5,248.07
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,584.89 / $2,398.83	Facility		$933.25	$1,584.89	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,230.27 / $1,621.81	Professional		$812.83	$1,230.27	$1,621.81