Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $6,309.57 / $12,022.64	Facility		$870.96	$6,309.57	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $707.95 / $1,819.70	Professional		$575.44	$707.95	$1,819.70
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 $512.86 / $676.08 / $1,071.52	Professional		$512.86	$676.08	$1,071.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $724.44	Facility		$616.60	$616.60	$724.44
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 $602.56 / $831.76 / $1,202.26	Professional		$602.56	$831.76	$1,202.26
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 $562.34 / $831.76 / $1,258.93	Professional		$562.34	$831.76	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
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 $575.44 / $676.08 / $1,288.25	Professional		$575.44	$676.08	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $9,332.54 / $13,803.84	Facility		$4,073.80	$9,332.54	$13,803.84
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $676.08 / $1,096.48	Professional		$457.09	$676.08	$1,096.48