Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $5,888.44 / $10,964.78	Facility		$870.96	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $489.78 / $3,235.94	Professional		$426.58	$489.78	$3,235.94
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 $389.05 / $501.19 / $812.83	Professional		$389.05	$501.19	$812.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $537.03	Facility		$457.09	$457.09	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $741.31 / $21,379.62	Facility		$446.68	$741.31	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $616.60 / $891.25	Professional		$446.68	$616.60	$891.25
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 $416.87 / $602.56 / $891.25	Professional		$416.87	$602.56	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $74.13	Professional		$32.36	$33.11	$74.13
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $2,511.89	Facility		$100.00	$100.00	$2,511.89
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $537.03 / $1,023.29	Professional		$457.09	$537.03	$1,023.29
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 $338.84 / $501.19 / $831.76	Professional		$338.84	$501.19	$831.76