Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $1,479.11	Facility		$870.96	$870.96	$1,479.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $891.25 / $1,318.26	Professional		$660.69	$891.25	$1,318.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,905.46 / $3,890.45	Facility		$1,819.70	$1,905.46	$3,890.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,047.13 / $2,344.23	Professional		$891.25	$1,047.13	$2,344.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,148.15 / $1,862.09	Facility		$776.25	$1,148.15	$1,862.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,380.38 / $2,089.30	Professional		$1,000.00	$1,380.38	$2,089.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,258.93	Professional		$912.01	$912.01	$1,258.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,230.27	Professional		$912.01	$912.01	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $851.14 / $1,230.27	Professional		$602.56	$851.14	$1,230.27
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility		$2,187.76	$2,187.76	$2,187.76
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,041.74 / $3,801.89	Professional		$1,819.70	$2,041.74	$3,801.89
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,148.15 / $1,778.28	Facility		$645.65	$1,148.15	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $891.25 / $1,174.90	Professional		$588.84	$891.25	$1,174.90