Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $7,585.78 / $13,803.84	Facility		$2,818.38	$7,585.78	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,089.30 / $6,606.93	Professional		$1,548.82	$2,089.30	$6,606.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,548.13 / $15,135.61	Facility		$1,698.24	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,698.24 / $2,754.23	Professional		$1,230.27	$1,698.24	$2,754.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $30,902.95 / $46,773.51	Facility		$2,089.30	$30,902.95	$46,773.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $34,673.69 / $61,659.50	Professional		$2,754.23	$34,673.69	$61,659.50
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 $3,388.44 / $3,388.44 / $3,388.44	Professional		$3,388.44	$3,388.44	$3,388.44
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 $3,388.44 / $3,388.44 / $10,232.93	Professional		$3,388.44	$3,388.44	$10,232.93
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 $15,848.93 / $15,848.93 / $15,848.93	Facility		$15,848.93	$15,848.93	$15,848.93
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 $4,265.80 / $9,332.54 / $14,125.38	Facility		$4,265.80	$9,332.54	$14,125.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,238.72 / $3,981.07	Professional		$1,318.26	$2,238.72	$3,981.07