Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $2,290.87	Facility		$1,230.27	$1,230.27	$2,290.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,230.27 / $1,862.09	Professional		$891.25	$1,230.27	$1,862.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,754.23 / $5,495.41	Facility		$2,570.40	$2,754.23	$5,495.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,513.56 / $3,311.31	Professional		$1,258.93	$1,513.56	$3,311.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,584.89 / $2,511.89	Facility		$1,047.13	$1,584.89	$2,511.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,905.46 / $2,818.38	Professional		$1,380.38	$1,905.46	$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 $1,202.26 / $1,202.26 / $1,621.81	Professional		$1,202.26	$1,202.26	$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 $1,202.26 / $1,202.26 / $1,380.38	Professional		$1,202.26	$1,202.26	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,548.82 / $2,238.72	Professional		$1,096.48	$1,548.82	$2,238.72
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Facility		$3,090.30	$3,090.30	$3,090.30
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,884.03 / $5,370.32	Professional		$2,570.40	$2,884.03	$5,370.32
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,548.82 / $2,344.23	Facility		$933.25	$1,548.82	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,258.93 / $1,621.81	Professional		$812.83	$1,258.93	$1,621.81