Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $5,888.44 / $10,964.78	Facility		$933.25	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $645.65 / $3,235.94	Professional		$562.34	$645.65	$3,235.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,388.44 / $15,135.61	Facility		$1,698.24	$3,388.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $1,380.38	Professional		$616.60	$851.14	$1,380.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $707.95	Facility		$602.56	$602.56	$707.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $977.24 / $21,379.62	Facility		$724.44	$977.24	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $851.14 / $1,258.93	Professional		$588.84	$851.14	$1,258.93
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 $549.54 / $851.14 / $1,258.93	Professional		$549.54	$851.14	$1,258.93
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 $588.84 / $691.83 / $1,318.26	Professional		$588.84	$691.83	$1,318.26
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $4,466.84 / $7,413.10	Facility		$2,454.71	$4,466.84	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $724.44 / $1,122.02	Professional		$467.74	$724.44	$1,122.02