Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $8,912.51 / $11,748.98	Facility		$1,023.29	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $977.24 / $1,905.46	Professional		$794.33	$977.24	$1,905.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,548.13 / $15,135.61	Facility		$1,698.24	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $954.99 / $1,513.56	Professional		$724.44	$954.99	$1,513.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $1,071.52	Facility		$912.01	$912.01	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,479.11 / $21,379.62	Facility		$954.99	$1,479.11	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,174.90 / $1,737.80	Professional		$831.76	$1,174.90	$1,737.80
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 $812.83 / $1,174.90 / $1,737.80	Professional		$812.83	$1,174.90	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $15,848.93	Facility		$100.00	$100.00	$15,848.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,023.29 / $1,949.84	Professional		$870.96	$1,023.29	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $9,332.54 / $14,125.38	Facility		$4,265.80	$9,332.54	$14,125.38
United Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $977.24 / $1,621.81	Professional		$676.08	$977.24	$1,621.81