Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $2,570.40 / $10,715.19	Facility		$128.82	$2,570.40	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $251.19	Professional		$83.18	$114.82	$251.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,884.03 / $7,943.28	Facility		$1,000.00	$2,884.03	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $208.93	Professional		$85.11	$125.89	$208.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Facility		$87.10	$87.10	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $141.25 / $21,379.62	Facility		$107.15	$141.25	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $229.09	Professional		$91.20	$141.25	$229.09
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 $89.13 / $141.25 / $223.87	Professional		$89.13	$141.25	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $74.13	Professional		$32.36	$33.11	$74.13
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,905.46	Facility		$100.00	$100.00	$1,905.46
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $194.98	Professional		$85.11	$128.82	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,691.53 / $5,248.07	Facility		$1,698.24	$2,691.53	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $186.21	Professional		$74.13	$114.82	$186.21