Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $7,079.46 / $12,022.64	Facility		$2,454.71	$7,079.46	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,137.96 / $5,128.61	Professional		$1,778.28	$2,137.96	$5,128.61
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 $1,778.28 / $2,344.23 / $3,630.78	Professional		$1,778.28	$2,344.23	$3,630.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $2,187.76	Facility		$1,862.09	$1,862.09	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,090.30 / $21,379.62	Facility		$2,344.23	$3,090.30	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $3,981.07	Professional		$1,819.70	$2,630.27	$3,981.07
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 $1,698.24 / $2,630.27 / $3,981.07	Professional		$1,698.24	$2,630.27	$3,981.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $371.54	Professional		$32.36	$33.11	$371.54
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $7,244.36	Facility		$100.00	$100.00	$7,244.36
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,995.26 / $3,801.89	Professional		$1,698.24	$1,995.26	$3,801.89
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,760.83 / $11,220.18	Facility		$3,890.45	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,290.87 / $3,548.13	Professional		$1,513.56	$2,290.87	$3,548.13