Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $7,585.78 / $12,589.25	Facility		$1,949.84	$7,585.78	$12,589.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,348.96 / $4,265.80	Professional		$1,174.90	$1,348.96	$4,265.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,548.13 / $15,135.61	Facility		$1,698.24	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,445.44 / $2,290.87	Professional		$1,122.02	$1,445.44	$2,290.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,479.11	Facility		$1,258.93	$1,258.93	$1,479.11
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 $1,230.27 / $1,737.80 / $2,570.40	Professional		$1,230.27	$1,737.80	$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 / $1,737.80 / $2,630.27	Professional		$1,122.02	$1,737.80	$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 / $1,412.54 / $2,691.53	Professional		$1,202.26	$1,412.54	$2,691.53
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 $977.24 / $1,445.44 / $2,290.87	Professional		$977.24	$1,445.44	$2,290.87