Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $5,888.44 / $10,964.78	Facility		$1,258.93	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $912.01 / $5,888.44	Professional		$776.25	$912.01	$5,888.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,388.44 / $15,135.61	Facility		$1,698.24	$3,388.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $933.25 / $1,548.82	Professional		$776.25	$933.25	$1,548.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
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 $794.33 / $1,148.15 / $1,862.09	Professional		$794.33	$1,148.15	$1,862.09
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 $776.25 / $1,174.90 / $1,819.70	Professional		$776.25	$1,174.90	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $588.84	Professional		$32.36	$33.11	$588.84
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $4,365.16	Facility		$100.00	$100.00	$4,365.16
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,000.00 / $1,995.26	Professional		$851.14	$1,000.00	$1,995.26
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,754.40 / $8,511.38	Facility		$2,818.38	$5,754.40	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $954.99 / $1,584.89	Professional		$707.95	$954.99	$1,584.89