Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $8,912.51 / $12,882.50	Facility		$2,398.83	$8,912.51	$12,882.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,445.44 / $6,165.95	Professional		$1,174.90	$1,445.44	$6,165.95
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 $1,096.48 / $1,445.44 / $2,290.87	Professional		$1,096.48	$1,445.44	$2,290.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,445.44	Facility		$1,230.27	$1,230.27	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $2,041.74 / $21,379.62	Facility		$1,445.44	$2,041.74	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,698.24 / $2,570.40	Professional		$1,202.26	$1,698.24	$2,570.40
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 $1,122.02 / $1,698.24 / $2,630.27	Professional		$1,122.02	$1,698.24	$2,630.27
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 $1,202.26 / $1,380.38 / $2,630.27	Professional		$1,202.26	$1,380.38	$2,630.27
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 $954.99 / $1,412.54 / $2,290.87	Professional		$954.99	$1,412.54	$2,290.87