Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $7,413.10 / $11,748.98	Facility		$1,659.59	$7,413.10	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $933.25 / $3,981.07	Professional		$812.83	$933.25	$3,981.07
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 $812.83 / $1,047.13 / $1,659.59	Professional		$812.83	$1,047.13	$1,659.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $1,023.29	Facility		$870.96	$870.96	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,412.54	Professional		$1,023.29	$1,023.29	$1,412.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,659.59	Professional		$1,513.56	$1,513.56	$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 $851.14 / $977.24 / $1,862.09	Professional		$851.14	$977.24	$1,862.09
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 $676.08 / $1,023.29 / $1,584.89	Professional		$676.08	$1,023.29	$1,584.89