Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $2,511.89	Facility		$1,584.89	$1,584.89	$2,511.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,584.89 / $2,344.23	Professional		$1,202.26	$1,584.89	$2,344.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $3,548.13 / $7,244.36	Facility		$3,388.44	$3,548.13	$7,244.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,949.84 / $4,265.80	Professional		$1,659.59	$1,949.84	$4,265.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $2,089.30 / $3,311.31	Facility		$1,380.38	$2,089.30	$3,311.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,511.89 / $3,801.89	Professional		$1,819.70	$2,511.89	$3,801.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,137.96	Facility		$2,137.96	$2,137.96	$2,137.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $2,137.96	Professional		$1,548.82	$1,548.82	$2,137.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,137.96	Facility		$2,137.96	$2,137.96	$2,137.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,862.09	Professional		$1,548.82	$1,548.82	$1,862.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,995.26 / $2,884.03	Professional		$1,412.54	$1,995.26	$2,884.03
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Facility		$3,981.07	$3,981.07	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,715.35 / $6,918.31	Professional		$3,388.44	$3,715.35	$6,918.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,089.30 / $3,235.94	Facility		$1,258.93	$2,089.30	$3,235.94
United Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,621.81 / $2,137.96	Professional		$1,096.48	$1,621.81	$2,137.96