Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $4,265.80 / $10,964.78	Facility		$794.33	$4,265.80	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $549.54 / $1,862.09	Professional		$426.58	$549.54	$1,862.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,388.44 / $15,135.61	Facility		$1,698.24	$3,388.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $645.65 / $1,071.52	Professional		$478.63	$645.65	$1,071.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $537.03	Facility		$457.09	$457.09	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $741.31 / $21,379.62	Facility		$660.69	$741.31	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $691.83 / $1,023.29	Professional		$446.68	$691.83	$1,023.29
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 $416.87 / $691.83 / $1,023.29	Professional		$416.87	$691.83	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $3,548.13	Facility		$100.00	$100.00	$3,548.13
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $512.86 / $977.24	Professional		$446.68	$512.86	$977.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,691.53 / $5,248.07	Facility		$1,778.28	$2,691.53	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $588.84 / $933.25	Professional		$371.54	$588.84	$933.25