Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $5,888.44 / $10,964.78	Facility		$891.25	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $524.81 / $3,235.94	Professional		$457.09	$524.81	$3,235.94
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 $407.38 / $537.03 / $831.76	Professional		$407.38	$537.03	$831.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $575.44	Facility		$489.78	$489.78	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $794.33 / $21,379.62	Facility		$512.86	$794.33	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $645.65 / $954.99	Professional		$467.74	$645.65	$954.99
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 $446.68 / $645.65 / $954.99	Professional		$446.68	$645.65	$954.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $79.43	Professional		$32.36	$33.11	$79.43
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 $489.78 / $575.44 / $1,096.48	Professional		$489.78	$575.44	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $6,025.60 / $9,120.11	Facility		$2,818.38	$6,025.60	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $524.81 / $870.96	Professional		$363.08	$524.81	$870.96