Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna 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
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,344.23 / $2,511.89	Professional		$2,238.72	$2,344.23	$2,511.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,819.70 / $2,818.38	Professional		$1,479.11	$1,819.70	$2,818.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Facility		$1,479.11	$1,479.11	$1,479.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,995.26	Professional		$1,479.11	$1,479.11	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,479.11	Facility		$1,412.54	$1,412.54	$1,479.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $2,137.96	Professional		$1,479.11	$1,479.11	$2,137.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,479.11	Facility		$1,412.54	$1,412.54	$1,479.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $2,398.83	Professional		$1,479.11	$1,479.11	$2,398.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $1,737.80 / $2,454.71	Professional		$33.11	$1,737.80	$2,454.71
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $3,090.30 / $5,011.87	Professional		$1,380.38	$3,090.30	$5,011.87
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,818.38 / $2,818.38	Professional		$1,479.11	$2,818.38	$2,818.38