Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,513.56	Facility		$1,000.00	$1,000.00	$1,513.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,000.00 / $1,621.81	Professional		$831.76	$1,000.00	$1,621.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,187.76 / $4,466.84	Facility		$2,089.30	$2,187.76	$4,466.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,230.27 / $2,691.53	Professional		$1,023.29	$1,230.27	$2,691.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,659.59 / $2,630.27	Facility		$1,096.48	$1,659.59	$2,630.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,995.26 / $2,951.21	Professional		$1,445.44	$1,995.26	$2,951.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $954.99 / $1,318.26	Professional		$954.99	$954.99	$1,318.26
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $954.99 / $1,258.93	Professional		$954.99	$954.99	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,698.24 / $2,454.71	Professional		$1,071.52	$1,698.24	$2,454.71
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility		$2,511.89	$2,511.89	$2,511.89
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,344.23 / $4,265.80	Professional		$2,089.30	$2,344.23	$4,265.80
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,348.96 / $2,041.74	Facility		$741.31	$1,348.96	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,000.00 / $1,380.38	Professional		$676.08	$1,000.00	$1,380.38