Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $9,549.93 / $11,748.98	Facility		$2,691.53	$9,549.93	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,905.46 / $2,951.21	Professional		$1,096.48	$1,905.46	$2,951.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $6,025.60 / $22,908.68	Facility		$3,235.94	$6,025.60	$22,908.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $602.56 / $977.24	Professional		$426.58	$602.56	$977.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $28,183.83 / $41,686.94	Facility		$1,862.09	$28,183.83	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $31,622.78 / $56,234.13	Professional		$2,454.71	$31,622.78	$56,234.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Professional		$3,090.30	$3,090.30	$3,090.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $9,120.11	Professional		$3,090.30	$3,090.30	$9,120.11
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 $8,912.51 / $8,912.51 / $8,912.51	Facility		$8,912.51	$8,912.51	$8,912.51
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 $2,951.21 / $6,025.60 / $9,332.54	Facility		$2,951.21	$6,025.60	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $1,348.96 / $2,630.27	Professional		$524.81	$1,348.96	$2,630.27