Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $8,912.51 / $11,748.98	Facility		$794.33	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $831.76 / $1,778.28	Professional		$660.69	$831.76	$1,778.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $11,481.54 / $24,547.09	Facility		$2,818.38	$11,481.54	$24,547.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $758.58 / $1,318.26	Professional		$588.84	$758.58	$1,318.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $707.95 / $831.76	Facility		$691.83	$707.95	$831.76
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 $630.96 / $954.99 / $1,479.11	Professional		$630.96	$954.99	$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 $645.65 / $977.24 / $1,513.56	Professional		$645.65	$977.24	$1,513.56
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 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $870.96 / $1,659.59	Professional		$741.31	$870.96	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $3,090.30 / $6,760.83	Facility		$1,479.11	$3,090.30	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $812.83 / $1,380.38	Professional		$602.56	$812.83	$1,380.38