Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $8,912.51 / $11,748.98	Facility		$1,548.82	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,513.56 / $3,890.45	Professional		$1,258.93	$1,513.56	$3,890.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $5,888.44 / $15,135.61	Facility		$1,949.84	$5,888.44	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,548.82 / $2,691.53	Professional		$1,174.90	$1,548.82	$2,691.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
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 $1,148.15 / $1,698.24 / $2,570.40	Professional		$1,148.15	$1,698.24	$2,570.40
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 $1,202.26 / $1,862.09 / $2,630.27	Professional		$1,202.26	$1,862.09	$2,630.27
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 Professional Modifier Low / Median / High Price $1,258.93 / $1,548.82 / $2,884.03	Professional		$1,258.93	$1,548.82	$2,884.03
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 $1,258.93 / $1,621.81 / $2,511.89	Professional		$1,258.93	$1,621.81	$2,511.89