Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $7,585.78 / $12,022.64	Facility		$2,290.87	$7,585.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,258.93 / $4,365.16	Professional		$1,122.02	$1,258.93	$4,365.16
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 $1,047.13 / $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 $1,174.90 / $1,174.90 / $1,380.38	Facility		$1,174.90	$1,174.90	$1,380.38
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 $1,148.15 / $1,621.81 / $2,398.83	Professional		$1,148.15	$1,621.81	$2,398.83
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 $1,071.52 / $1,621.81 / $2,454.71	Professional		$1,071.52	$1,621.81	$2,454.71
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 $1,148.15 / $1,348.96 / $2,511.89	Professional		$1,148.15	$1,348.96	$2,511.89
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 / $1,348.96 / $2,187.76	Professional		$912.01	$1,348.96	$2,187.76