Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $7,585.78 / $12,022.64	Facility		$1,230.27	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $870.96 / $3,981.07	Professional		$758.58	$870.96	$3,981.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $5,370.32 / $30,199.52	Facility		$2,137.96	$5,370.32	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $870.96 / $1,380.38	Professional		$676.08	$870.96	$1,380.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $933.25	Facility		$794.33	$794.33	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,318.26 / $21,379.62	Facility		$891.25	$1,318.26	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,096.48 / $1,584.89	Professional		$794.33	$1,096.48	$1,584.89
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 $724.44 / $1,096.48 / $1,659.59	Professional		$724.44	$1,096.48	$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 / $15,848.93	Facility		$100.00	$100.00	$15,848.93
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $912.01 / $1,737.80	Professional		$776.25	$912.01	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,918.31 / $11,220.18	Facility		$3,890.45	$6,918.31	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $912.01 / $1,445.44	Professional		$602.56	$912.01	$1,445.44