Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $7,585.78 / $12,022.64	Facility		$1,288.25	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $891.25 / $3,715.35	Professional		$776.25	$891.25	$3,715.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $7,079.46 / $22,908.68	Facility		$3,090.30	$7,079.46	$22,908.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,000.00 / $1,584.89	Professional		$758.58	$1,000.00	$1,584.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $977.24	Facility		$831.76	$831.76	$977.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,348.96 / $21,379.62	Facility		$954.99	$1,348.96	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,148.15 / $1,659.59	Professional		$812.83	$1,148.15	$1,659.59
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 $741.31 / $1,122.02 / $1,737.80	Professional		$741.31	$1,122.02	$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 / $8,912.51	Facility		$100.00	$100.00	$8,912.51
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $933.25 / $1,778.28	Professional		$794.33	$933.25	$1,778.28
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 $645.65 / $954.99 / $1,513.56	Professional		$645.65	$954.99	$1,513.56