Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $2,290.87	Facility		$1,445.44	$1,445.44	$2,290.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,479.11 / $2,344.23	Professional		$1,258.93	$1,479.11	$2,344.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,235.94 / $6,456.54	Facility		$3,019.95	$3,235.94	$6,456.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,698.24 / $3,890.45	Professional		$1,412.54	$1,698.24	$3,890.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,479.11 / $3,311.31	Facility		$870.96	$1,479.11	$3,311.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,905.46 / $3,981.07	Professional		$758.58	$1,905.46	$3,981.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility		$2,398.83	$2,398.83	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,398.83	Professional		$1,995.26	$1,995.26	$2,398.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility		$2,398.83	$2,398.83	$2,398.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional		$1,995.26	$1,995.26	$1,995.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $2,238.72 / $3,235.94	Professional		$933.25	$2,238.72	$3,235.94
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $3,630.78	Facility		$25.70	$25.70	$3,630.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,388.44 / $6,309.57	Professional		$3,019.95	$3,388.44	$6,309.57
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,698.24 / $2,238.72	Facility		$707.95	$1,698.24	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,479.11 / $2,041.74	Professional		$1,000.00	$1,479.11	$2,041.74