Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $7,585.78 / $12,022.64	Facility		$1,698.24	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,174.90 / $3,981.07	Professional		$1,023.29	$1,174.90	$3,981.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,754.40 / $22,908.68	Facility		$3,090.30	$5,754.40	$22,908.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,288.25 / $2,041.74	Professional		$1,000.00	$1,288.25	$2,041.74
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Professional		$1,202.26	$1,202.26	$1,202.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,288.25	Facility		$1,096.48	$1,096.48	$1,288.25
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 $1,071.52 / $1,513.56 / $2,238.72	Professional		$1,071.52	$1,513.56	$2,238.72
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 $977.24 / $1,513.56 / $2,290.87	Professional		$977.24	$1,513.56	$2,290.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $213.80	Professional		$32.36	$33.11	$213.80
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $8,912.51	Facility		$100.00	$100.00	$8,912.51
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,230.27 / $2,290.87	Professional		$1,047.13	$1,230.27	$2,290.87
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 $851.14 / $1,258.93 / $1,995.26	Professional		$851.14	$1,258.93	$1,995.26