Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $4,570.88 / $10,964.78	Facility		$776.25	$4,570.88	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $676.08 / $1,412.54	Professional		$501.19	$676.08	$1,412.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $3,019.95 / $7,943.28	Facility		$1,000.00	$3,019.95	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $537.03 / $1,096.48	Professional		$363.08	$537.03	$1,096.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $645.65	Facility		$549.54	$549.54	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $870.96 / $21,379.62	Facility		$478.63	$870.96	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $758.58 / $1,174.90	Professional		$489.78	$758.58	$1,174.90
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 $501.19 / $758.58 / $1,174.90	Professional		$501.19	$758.58	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $316.23	Professional		$32.36	$33.11	$316.23
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $4,073.80	Facility		$100.00	$100.00	$4,073.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $776.25 / $1,348.96	Professional		$588.84	$776.25	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $4,466.84 / $7,413.10	Facility		$2,454.71	$4,466.84	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $575.44 / $1,000.00	Professional		$380.19	$575.44	$1,000.00