Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $7,413.10 / $12,022.64	Facility		$2,818.38	$7,413.10	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,754.23 / $6,760.83	Professional		$2,398.83	$2,754.23	$6,760.83
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 $2,398.83 / $3,235.94 / $5,128.61	Professional		$2,398.83	$3,235.94	$5,128.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,951.21	Facility		$2,454.71	$2,454.71	$2,951.21
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 $2,454.71 / $3,548.13 / $5,248.07	Professional		$2,454.71	$3,548.13	$5,248.07
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 $2,238.72 / $3,548.13 / $5,248.07	Professional		$2,238.72	$3,548.13	$5,248.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $489.78	Professional		$32.36	$33.11	$489.78
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 $2,290.87 / $2,630.27 / $5,011.87	Professional		$2,290.87	$2,630.27	$5,011.87
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 $1,949.84 / $3,019.95 / $4,677.35	Professional		$1,949.84	$3,019.95	$4,677.35