Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,995.26 / $3,162.28	Professional		$1,380.38	$1,995.26	$3,162.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $3,162.28	Professional		$204.17	$251.19	$3,162.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $34,673.69 / $52,480.75	Facility		$2,344.23	$34,673.69	$52,480.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $39,810.72 / $69,183.10	Professional		$3,090.30	$39,810.72	$69,183.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,471.29 / $10,471.29 / $10,471.29	Facility		$10,471.29	$10,471.29	$10,471.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $3,235.94	Professional		$2,884.03	$2,884.03	$3,235.94
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $10,471.29 / $10,471.29 / $10,471.29	Facility		$10,471.29	$10,471.29	$10,471.29
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,630.27 / $5,888.44	Professional		$1,905.46	$2,630.27	$5,888.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $3,467.37	Professional		$1,047.13	$1,513.56	$3,467.37