Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $7,413.10 / $12,022.64	Facility		$3,467.37	$7,413.10	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,388.44 / $7,413.10	Professional		$2,951.21	$3,388.44	$7,413.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,548.13 / $15,135.61	Facility		$1,698.24	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,311.31 / $5,248.07	Professional		$2,454.71	$3,311.31	$5,248.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,715.35	Facility		$3,162.28	$3,162.28	$3,715.35
Cigna 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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $4,168.69 / $6,165.95	Professional		$3,019.95	$4,168.69	$6,165.95
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 $2,818.38 / $4,168.69 / $6,165.95	Professional		$2,818.38	$4,168.69	$6,165.95
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 $3,019.95 / $3,548.13 / $6,606.93	Professional		$3,019.95	$3,548.13	$6,606.93
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $6,760.83 / $11,220.18	Facility		$3,235.94	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,388.44 / $5,754.40	Professional		$2,344.23	$3,388.44	$5,754.40