Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $7,585.78 / $11,748.98	Facility		$1,513.56	$7,585.78	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,071.52 / $3,801.89	Professional		$933.25	$1,071.52	$3,801.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,754.40 / $22,908.68	Facility		$3,090.30	$5,754.40	$22,908.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,096.48 / $1,737.80	Professional		$831.76	$1,096.48	$1,737.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,148.15	Facility		$977.24	$977.24	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $21,379.62	Facility		$1,047.13	$1,621.81	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,348.96 / $1,949.84	Professional		$954.99	$1,348.96	$1,949.84
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 $891.25 / $1,288.25 / $1,949.84	Professional		$891.25	$1,288.25	$1,949.84
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 $977.24 / $1,148.15 / $2,137.96	Professional		$977.24	$1,148.15	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,760.83 / $11,220.18	Facility		$3,890.45	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,071.52 / $1,698.24	Professional		$724.44	$1,071.52	$1,698.24