Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $6,309.57 / $12,022.64	Facility		$1,584.89	$6,309.57	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,318.26 / $4,073.80	Professional		$1,148.15	$1,318.26	$4,073.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $7,079.46 / $30,199.52	Facility		$2,137.96	$7,079.46	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,348.96 / $2,137.96	Professional		$1,047.13	$1,348.96	$2,137.96
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 $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,659.59 / $2,454.71	Professional		$1,202.26	$1,659.59	$2,454.71
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 / $1,659.59 / $2,570.40	Professional		$1,122.02	$1,659.59	$2,570.40
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 / $15,848.93	Facility		$100.00	$100.00	$15,848.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,380.38 / $2,630.27	Professional		$1,174.90	$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 $912.01 / $1,380.38 / $2,238.72	Professional		$912.01	$1,380.38	$2,238.72