Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,290.87	Facility		$1,949.84	$1,949.84	$2,290.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,290.87	Professional		$1,949.84	$1,949.84	$2,290.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $1,995.26 / $3,388.44	Professional		$208.93	$1,995.26	$3,388.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility		$1,949.84	$1,949.84	$1,949.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,630.27	Professional		$1,949.84	$1,949.84	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,949.84	Facility		$1,862.09	$1,862.09	$1,949.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,398.83	Professional		$1,949.84	$1,949.84	$2,398.83
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,949.84	Facility		$1,862.09	$1,862.09	$1,949.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,691.53	Professional		$1,949.84	$1,949.84	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $2,137.96	Professional		$39.81	$60.26	$2,137.96
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 / $2,344.23	Professional		$123.03	$144.54	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,995.26 / $1,995.26	Professional		$125.89	$1,995.26	$1,995.26