Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $5,888.44 / $10,964.78	Facility		$1,202.26	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $660.69 / $3,235.94	Professional		$575.44	$660.69	$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 $549.54 / $707.95 / $1,096.48	Professional		$549.54	$707.95	$1,096.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $741.31	Facility		$630.96	$630.96	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,023.29 / $21,379.62	Facility		$691.83	$1,023.29	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $1,230.27	Professional		$616.60	$851.14	$1,230.27
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 $562.34 / $851.14 / $1,288.25	Professional		$562.34	$851.14	$1,288.25
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 / $3,981.07	Facility		$100.00	$100.00	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $707.95 / $1,348.96	Professional		$602.56	$707.95	$1,348.96
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 $467.74 / $691.83 / $1,122.02	Professional		$467.74	$691.83	$1,122.02