Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $3,388.44 / $10,715.19	Facility		$602.56	$3,388.44	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $537.03 / $1,122.02	Professional		$354.81	$537.03	$1,122.02
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 $331.13 / $436.52 / $707.95	Professional		$331.13	$436.52	$707.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $457.09	Facility		$389.05	$389.05	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $588.84 / $21,379.62	Facility		$398.11	$588.84	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $602.56 / $1,000.00	Professional		$389.05	$602.56	$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 $389.05 / $602.56 / $954.99	Professional		$389.05	$602.56	$954.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $177.83	Professional		$32.36	$33.11	$177.83
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $3,548.13	Facility		$100.00	$100.00	$3,548.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $660.69 / $1,000.00	Professional		$389.05	$660.69	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,691.53 / $5,248.07	Facility		$1,778.28	$2,691.53	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $512.86 / $851.14	Professional		$309.03	$512.86	$851.14