Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $8,912.51 / $11,748.98	Facility		$2,570.40	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,511.89 / $4,897.79	Professional		$2,137.96	$2,511.89	$4,897.79
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 $1,949.84 / $2,511.89 / $3,981.07	Professional		$1,949.84	$2,511.89	$3,981.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,754.23	Facility		$2,344.23	$2,344.23	$2,754.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,890.45 / $21,379.62	Facility		$2,570.40	$3,890.45	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,090.30 / $4,570.88	Professional		$2,187.76	$3,090.30	$4,570.88
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 $2,089.30 / $3,090.30 / $4,677.35	Professional		$2,089.30	$3,090.30	$4,677.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $331.13	Professional		$32.36	$33.11	$331.13
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 $2,187.76 / $2,570.40 / $4,897.79	Professional		$2,187.76	$2,570.40	$4,897.79
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 $1,778.28 / $2,570.40 / $4,265.80	Professional		$1,778.28	$2,570.40	$4,265.80