Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $2,884.03	Facility		$1,659.59	$1,659.59	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,698.24 / $2,818.38	Professional		$1,445.44	$1,698.24	$2,818.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,715.35 / $7,413.10	Facility		$3,467.37	$3,715.35	$7,413.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,995.26 / $4,466.84	Professional		$1,698.24	$1,995.26	$4,466.84
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Professional		$2,884.03	$2,884.03	$2,884.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,570.40 / $4,168.69	Facility		$1,737.80	$2,570.40	$4,168.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,090.30 / $4,677.35	Professional		$2,238.72	$3,090.30	$4,677.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility		$2,238.72	$2,238.72	$2,238.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $2,238.72	Professional		$1,621.81	$1,621.81	$2,238.72
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility		$2,238.72	$2,238.72	$2,238.72
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $2,238.72	Professional		$1,621.81	$1,621.81	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,754.23 / $3,890.45	Professional		$1,949.84	$2,754.23	$3,890.45
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Facility		$4,168.69	$4,168.69	$4,168.69
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,890.45 / $7,244.36	Professional		$3,467.37	$3,890.45	$7,244.36
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,290.87 / $3,548.13	Facility		$1,258.93	$2,290.87	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,698.24 / $2,344.23	Professional		$1,148.15	$1,698.24	$2,344.23