Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $5,888.44 / $10,964.78	Facility		$1,258.93	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $794.33 / $3,235.94	Professional		$691.83	$794.33	$3,235.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $7,244.36 / $23,988.33	Facility		$2,884.03	$7,244.36	$23,988.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $831.76 / $1,318.26	Professional		$630.96	$831.76	$1,318.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $870.96	Facility		$741.31	$741.31	$870.96
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 $724.44 / $1,000.00 / $1,479.11	Professional		$724.44	$1,000.00	$1,479.11
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 $676.08 / $1,000.00 / $1,548.82	Professional		$676.08	$1,000.00	$1,548.82
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 $724.44 / $851.14 / $1,584.89	Professional		$724.44	$851.14	$1,584.89
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 $549.54 / $831.76 / $1,348.96	Professional		$549.54	$831.76	$1,348.96