Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $8,912.51 / $12,022.64	Facility		$3,235.94	$8,912.51	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,288.25 / $6,165.95	Professional		$891.25	$1,288.25	$6,165.95
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 $2,089.30 / $2,818.38 / $4,365.16	Professional		$2,089.30	$2,818.38	$4,365.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $16,218.10 / $41,686.94	Facility		$1,071.52	$16,218.10	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $18,197.01 / $31,622.78	Professional		$1,412.54	$18,197.01	$31,622.78
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 $2,089.30 / $2,089.30 / $2,089.30	Professional		$2,089.30	$2,089.30	$2,089.30
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 $2,089.30 / $2,089.30 / $5,888.44	Professional		$2,089.30	$2,089.30	$5,888.44
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 $954.99 / $1,548.82 / $2,344.23	Professional		$954.99	$1,548.82	$2,344.23