Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $7,413.10 / $12,022.64	Facility		$3,019.95	$7,413.10	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,019.95 / $7,244.36	Professional		$2,570.40	$3,019.95	$7,244.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $7,079.46 / $22,908.68	Facility		$3,235.94	$7,079.46	$22,908.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,235.94 / $5,128.61	Professional		$2,454.71	$3,235.94	$5,128.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $3,235.94	Facility		$2,754.23	$2,754.23	$3,235.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $4,466.84 / $21,379.62	Facility		$3,235.94	$4,466.84	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,890.45 / $5,754.40	Professional		$2,691.53	$3,890.45	$5,754.40
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 $2,454.71 / $3,801.89 / $5,754.40	Professional		$2,454.71	$3,801.89	$5,754.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $549.54	Professional		$32.36	$33.11	$549.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $8,912.51	Facility		$100.00	$100.00	$8,912.51
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,019.95 / $5,754.40	Professional		$2,570.40	$3,019.95	$5,754.40
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $6,760.83 / $11,220.18	Facility		$3,235.94	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,235.94 / $5,128.61	Professional		$2,137.96	$3,235.94	$5,128.61