Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $5,888.44 / $10,964.78	Facility		$1,047.13	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $724.44 / $3,235.94	Professional		$630.96	$724.44	$3,235.94
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 $616.60 / $794.33 / $1,230.27	Professional		$616.60	$794.33	$1,230.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $794.33	Facility		$676.08	$676.08	$794.33
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 $660.69 / $933.25 / $1,348.96	Professional		$660.69	$933.25	$1,348.96
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 $616.60 / $933.25 / $1,412.54	Professional		$616.60	$933.25	$1,412.54
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 / $3,981.07	Facility		$100.00	$100.00	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $776.25 / $1,479.11	Professional		$660.69	$776.25	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $6,025.60 / $9,120.11	Facility		$2,818.38	$6,025.60	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $776.25 / $1,202.26	Professional		$512.86	$776.25	$1,202.26