Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $2,570.40 / $10,715.19	Facility		$263.03	$2,570.40	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $630.96	Professional		$218.78	$251.19	$630.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,754.23 / $7,943.28	Facility		$1,000.00	$2,754.23	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $229.09 / $380.19	Professional		$162.18	$229.09	$380.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $281.84	Facility		$239.88	$239.88	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $380.19 / $21,379.62	Facility		$234.42	$380.19	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $316.23 / $457.09	Professional		$229.09	$316.23	$457.09
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 $218.78 / $316.23 / $446.68	Professional		$218.78	$316.23	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $114.82	Professional		$32.36	$33.11	$114.82
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,995.26	Facility		$100.00	$100.00	$1,995.26
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $562.34	Professional		$245.47	$288.40	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,691.53 / $5,248.07	Facility		$1,698.24	$2,691.53	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $407.38	Professional		$169.82	$251.19	$407.38