Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $5,888.44 / $10,964.78	Facility		$2,089.30	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $812.83 / $3,981.07	Professional		$512.86	$812.83	$3,981.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $3,548.13 / $16,982.44	Facility		$1,071.52	$3,548.13	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,023.29 / $1,584.89	Professional		$776.25	$1,023.29	$1,584.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $12,882.50 / $45,708.82	Facility		$831.76	$12,882.50	$45,708.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $14,125.38 / $25,118.86	Professional		$1,122.02	$14,125.38	$25,118.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,202.26 / $1,479.11	Facility		$524.81	$1,202.26	$1,479.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,380.38 / $4,073.80	Professional		$1,122.02	$1,380.38	$4,073.80
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,202.26 / $1,479.11	Facility		$524.81	$1,202.26	$1,479.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $4,073.80 / $4,073.80	Professional		$1,096.48	$4,073.80	$4,073.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $60.26	Professional		$32.36	$50.12	$60.26
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $7,413.10 / $7,413.10 / $7,413.10	Facility		$7,413.10	$7,413.10	$7,413.10
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $75.86	Professional		$50.12	$60.26	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $5,128.61 / $9,120.11	Facility		$933.25	$5,128.61	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $524.81 / $1,122.02	Professional		$234.42	$524.81	$1,122.02