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 $776.25 / $912.01 / $3,235.94	Professional		$776.25	$912.01	$3,235.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $5,370.32 / $22,908.68	Facility		$2,238.72	$5,370.32	$22,908.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $977.24 / $1,584.89	Professional		$758.58	$977.24	$1,584.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $954.99	Facility		$812.83	$812.83	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,380.38 / $21,379.62	Facility		$891.25	$1,380.38	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,122.02 / $1,621.81	Professional		$794.33	$1,122.02	$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 / $1,122.02 / $1,659.59	Professional		$758.58	$1,122.02	$1,659.59
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 $831.76 / $977.24 / $1,862.09	Professional		$831.76	$977.24	$1,862.09
United Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $6,025.60 / $9,332.54	Facility		$2,951.21	$6,025.60	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $933.25 / $1,445.44	Professional		$630.96	$933.25	$1,445.44