Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $3,715.35 / $10,715.19	Facility		$1,778.28	$3,715.35	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,089.30 / $4,265.80	Professional		$1,621.81	$2,089.30	$4,265.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $4,365.16 / $16,982.44	Facility		$1,995.26	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,819.70 / $3,162.28	Professional		$1,412.54	$1,819.70	$3,162.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,737.80 / $1,905.46	Facility		$1,584.89	$1,737.80	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,905.46 / $21,379.62	Facility		$1,445.44	$1,905.46	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $2,137.96 / $3,388.44	Professional		$389.05	$2,137.96	$3,388.44
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 / $2,187.76 / $3,388.44	Professional		$389.05	$2,187.76	$3,388.44
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 / $7,244.36	Facility		$100.00	$100.00	$7,244.36
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,862.09 / $3,548.13	Professional		$1,584.89	$1,862.09	$3,548.13
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,606.93 / $10,964.78	Facility		$3,890.45	$6,606.93	$10,964.78
United Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,862.09 / $3,235.94	Professional		$1,412.54	$1,862.09	$3,235.94