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 $186.21 / $251.19 / $302.00	Professional		$186.21	$251.19	$302.00
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 $295.12 / $398.11 / $630.96	Professional		$295.12	$398.11	$630.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $4,677.35 / $41,686.94	Facility		$309.03	$4,677.35	$41,686.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $5,248.07 / $9,332.54	Professional		$407.38	$5,248.07	$9,332.54
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 $436.52 / $436.52 / $436.52	Professional		$436.52	$436.52	$436.52
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 $436.52 / $436.52 / $1,047.13	Professional		$436.52	$436.52	$1,047.13
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 $50.12 / $60.26 / $75.86	Professional		$50.12	$60.26	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $6,760.83 / $10,964.78	Facility		$3,548.13	$6,760.83	$10,964.78
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $346.74 / $537.03	Professional		$204.17	$346.74	$537.03