Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,445.44	Facility		$1,230.27	$1,230.27	$1,445.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,445.44	Professional		$1,230.27	$1,230.27	$1,445.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $1,348.96 / $2,137.96	Professional		$199.53	$1,348.96	$2,137.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,659.59	Professional		$1,230.27	$1,230.27	$1,659.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,230.27	Facility		$1,174.90	$1,174.90	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,698.24	Professional		$1,230.27	$1,230.27	$1,698.24
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,230.27	Facility		$1,174.90	$1,174.90	$1,230.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,737.80	Professional		$1,230.27	$1,230.27	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $1,348.96	Professional		$39.81	$60.26	$1,348.96
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 / $2,041.74	Professional		$123.03	$144.54	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,047.13 / $1,412.54	Professional		$125.89	$1,047.13	$1,412.54