Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,888.44 / $10,964.78	Facility		$1,698.24	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,412.54 / $4,570.88	Professional		$1,148.15	$1,412.54	$4,570.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $4,677.35 / $15,135.61	Facility		$1,949.84	$4,677.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,412.54 / $2,454.71	Professional		$1,096.48	$1,412.54	$2,454.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,230.27 / $1,380.38	Facility		$1,148.15	$1,230.27	$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 $331.13 / $1,621.81 / $2,454.71	Professional		$331.13	$1,621.81	$2,454.71
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 $331.13 / $1,621.81 / $2,511.89	Professional		$331.13	$1,621.81	$2,511.89
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 / $8,709.64	Facility		$100.00	$100.00	$8,709.64
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,258.93 / $2,398.83	Professional		$1,071.52	$1,258.93	$2,398.83
United Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,754.40 / $9,120.11	Facility		$2,951.21	$5,754.40	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,380.38 / $2,344.23	Professional		$1,047.13	$1,380.38	$2,344.23