Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $8,912.51 / $11,748.98	Facility		$2,691.53	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,630.27 / $4,897.79	Professional		$2,137.96	$2,630.27	$4,897.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $16,982.44	Facility		$2,238.72	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,630.27 / $4,265.80	Professional		$1,949.84	$2,630.27	$4,265.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
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 $1,905.46 / $2,884.03 / $4,570.88	Professional		$1,905.46	$2,884.03	$4,570.88
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 $2,041.74 / $3,019.95 / $4,786.30	Professional		$2,041.74	$3,019.95	$4,786.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$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 $2,041.74 / $2,511.89 / $4,786.30	Professional		$2,041.74	$2,511.89	$4,786.30
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 $2,238.72 / $2,818.38 / $4,365.16	Professional		$2,238.72	$2,818.38	$4,365.16