Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $7,585.78 / $12,022.64	Facility		$2,398.83	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,778.28 / $5,623.41	Professional		$1,548.82	$1,778.28	$5,623.41
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 $1,479.11 / $1,949.84 / $3,090.30	Professional		$1,479.11	$1,949.84	$3,090.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,949.84	Facility		$1,659.59	$1,659.59	$1,949.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,691.53 / $21,379.62	Facility		$1,949.84	$2,691.53	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,344.23 / $3,388.44	Professional		$1,621.81	$2,344.23	$3,388.44
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 $1,479.11 / $2,290.87 / $3,467.37	Professional		$1,479.11	$2,290.87	$3,467.37
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 $1,548.82 / $1,819.70 / $3,467.37	Professional		$1,548.82	$1,819.70	$3,467.37
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 $1,318.26 / $1,949.84 / $3,090.30	Professional		$1,318.26	$1,949.84	$3,090.30