Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $5,888.44 / $10,964.78	Facility		$1,380.38	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $954.99 / $3,467.37	Professional		$831.76	$954.99	$3,467.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $7,079.46 / $22,908.68	Facility		$2,238.72	$7,079.46	$22,908.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,202.26 / $1,995.26	Professional		$912.01	$1,202.26	$1,995.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $1,047.13	Facility		$891.25	$891.25	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $21,379.62	Facility		$1,071.52	$1,445.44	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,258.93 / $1,862.09	Professional		$870.96	$1,258.93	$1,862.09
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 / $1,258.93 / $1,862.09	Professional		$812.83	$1,258.93	$1,862.09
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 $870.96 / $1,000.00 / $1,905.46	Professional		$870.96	$1,000.00	$1,905.46
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 $707.95 / $1,071.52 / $1,621.81	Professional		$707.95	$1,071.52	$1,621.81