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 $83.18 / $158.49 / $190.55	Professional		$83.18	$158.49	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $16,982.44	Facility		$2,238.72	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $537.03 / $891.25	Professional		$398.11	$537.03	$891.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $2,398.83 / $45,708.82	Facility		$158.49	$2,398.83	$45,708.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $2,630.27 / $4,677.35	Professional		$208.93	$2,630.27	$4,677.35
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
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
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 $5,370.32 / $5,370.32 / $5,370.32	Facility		$5,370.32	$5,370.32	$5,370.32
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $75.86	Professional		$60.26	$60.26	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $6,606.93 / $10,471.29	Facility		$3,548.13	$6,606.93	$10,471.29
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $302.00	Professional		$131.83	$190.55	$302.00