Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,230.27	Facility		$1,047.13	$1,047.13	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,148.15	Professional		$1,047.13	$1,047.13	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $1,047.13 / $1,819.70	Professional		$190.55	$1,047.13	$1,819.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,412.54	Professional		$1,047.13	$1,047.13	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,047.13	Facility		$1,000.00	$1,000.00	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,047.13	Facility		$1,000.00	$1,000.00	$1,047.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,445.44	Professional		$1,047.13	$1,047.13	$1,445.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $1,318.26	Professional		$87.10	$117.49	$1,318.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $144.54 / $158.49	Facility		$134.90	$144.54	$158.49
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $144.54 / $309.03	Professional		$123.03	$144.54	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $302.00 / $1,000.00	Professional		$125.89	$302.00	$1,000.00