Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $3,715.35 / $10,715.19	Facility		$954.99	$3,715.35	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $676.08 / $2,511.89	Professional		$588.84	$676.08	$2,511.89
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 $645.65 / $912.01 / $1,445.44	Professional		$645.65	$912.01	$1,445.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $724.44	Facility		$616.60	$616.60	$724.44
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 $602.56 / $891.25 / $1,318.26	Professional		$602.56	$891.25	$1,318.26
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 $562.34 / $891.25 / $1,318.26	Professional		$562.34	$891.25	$1,318.26
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 / $8,912.51	Facility		$100.00	$100.00	$8,912.51
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $724.44 / $1,348.96	Professional		$616.60	$724.44	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $6,025.60 / $9,332.54	Facility		$2,951.21	$6,025.60	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $741.31 / $1,148.15	Professional		$489.78	$741.31	$1,148.15