Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $8,912.51 / $12,022.64	Facility		$3,090.30	$8,912.51	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,951.21 / $9,120.11	Professional		$2,570.40	$2,951.21	$9,120.11
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 $2,290.87 / $3,019.95 / $4,786.30	Professional		$2,290.87	$3,019.95	$4,786.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $3,162.28	Facility		$2,691.53	$2,691.53	$3,162.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $4,466.84 / $21,379.62	Facility		$3,090.30	$4,466.84	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,715.35 / $5,495.41	Professional		$2,511.89	$3,715.35	$5,495.41
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 $2,454.71 / $3,715.35 / $5,623.41	Professional		$2,454.71	$3,715.35	$5,623.41
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 $2,570.40 / $2,951.21 / $5,623.41	Professional		$2,570.40	$2,951.21	$5,623.41
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $9,332.54 / $14,125.38	Facility		$4,265.80	$9,332.54	$14,125.38
United Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,090.30 / $5,011.87	Professional		$2,089.30	$3,090.30	$5,011.87