Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,659.59	Facility		$1,412.54	$1,412.54	$1,659.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,584.89	Professional		$1,412.54	$1,412.54	$1,584.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $1,479.11 / $2,511.89	Professional		$204.17	$1,479.11	$2,511.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,905.46	Professional		$1,412.54	$1,412.54	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,412.54	Facility		$1,348.96	$1,348.96	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,737.80	Professional		$1,412.54	$1,412.54	$1,737.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,412.54	Facility		$1,348.96	$1,348.96	$1,412.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $2,041.74	Professional		$1,412.54	$1,412.54	$2,041.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $1,778.28	Professional		$87.10	$117.49	$1,778.28
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 / $2,137.96	Professional		$123.03	$144.54	$2,137.96
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,380.38 / $1,445.44	Professional		$125.89	$1,380.38	$1,445.44