Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $5,888.44 / $10,964.78	Facility		$1,288.25	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $912.01 / $3,235.94	Professional		$794.33	$912.01	$3,235.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,715.35 / $15,135.61	Facility		$1,698.24	$3,715.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,000.00 / $1,621.81	Professional		$758.58	$1,000.00	$1,621.81
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 $912.01 / $1,380.38 / $21,379.62	Facility		$912.01	$1,380.38	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,148.15 / $1,621.81	Professional		$812.83	$1,148.15	$1,621.81
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 $758.58 / $1,148.15 / $1,698.24	Professional		$758.58	$1,148.15	$1,698.24
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 $851.14 / $1,000.00 / $1,905.46	Professional		$851.14	$1,000.00	$1,905.46
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 $630.96 / $933.25 / $1,479.11	Professional		$630.96	$933.25	$1,479.11