Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $5,888.44 / $10,964.78	Facility		$891.25	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $575.44 / $2,238.72	Professional		$457.09	$575.44	$2,238.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,388.44 / $15,135.61	Facility		$1,698.24	$3,388.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $457.09 / $776.25	Professional		$338.84	$457.09	$776.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $616.60	Facility		$524.81	$524.81	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $812.83 / $21,379.62	Facility		$457.09	$812.83	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $660.69 / $1,000.00	Professional		$478.63	$660.69	$1,000.00
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 $457.09 / $660.69 / $1,000.00	Professional		$457.09	$660.69	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $72.44	Professional		$32.36	$33.11	$72.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $3,981.07	Facility		$100.00	$100.00	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $676.08 / $1,288.25	Professional		$575.44	$676.08	$1,288.25
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 $363.08 / $537.03 / $912.01	Professional		$363.08	$537.03	$912.01