Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $5,754.40 / $10,964.78	Facility		$1,445.44	$5,754.40	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,023.29 / $3,630.78	Professional		$891.25	$1,023.29	$3,630.78
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 $954.99 / $1,258.93 / $2,089.30	Professional		$954.99	$1,258.93	$2,089.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $1,096.48	Facility		$933.25	$933.25	$1,096.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,548.82 / $21,379.62	Facility		$1,174.90	$1,548.82	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,348.96 / $2,041.74	Professional		$912.01	$1,348.96	$2,041.74
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 $851.14 / $1,348.96 / $2,041.74	Professional		$851.14	$1,348.96	$2,041.74
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 $912.01 / $1,071.52 / $1,995.26	Professional		$912.01	$1,071.52	$1,995.26
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 $741.31 / $1,148.15 / $1,778.28	Professional		$741.31	$1,148.15	$1,778.28