Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $2,570.40 / $10,715.19	Facility		$602.56	$2,570.40	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $575.44 / $1,122.02	Professional		$371.54	$575.44	$1,122.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $3,548.13 / $15,135.61	Facility		$1,548.82	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $537.03	Professional		$208.93	$269.15	$537.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $457.09	Facility		$389.05	$389.05	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $630.96 / $21,379.62	Facility		$380.19	$630.96	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $588.84 / $1,023.29	Professional		$389.05	$588.84	$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 $389.05 / $588.84 / $1,023.29	Professional		$389.05	$588.84	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $190.55	Professional		$32.36	$33.11	$190.55
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $3,981.07	Facility		$100.00	$100.00	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $660.69 / $1,000.00	Professional		$389.05	$660.69	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $4,466.84 / $7,413.10	Facility		$2,454.71	$4,466.84	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $501.19 / $912.01	Professional		$309.03	$501.19	$912.01