Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $8,912.51 / $11,748.98	Facility		$1,698.24	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,659.59 / $3,311.31	Professional		$1,348.96	$1,659.59	$3,311.31
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 $1,174.90 / $1,621.81 / $2,630.27	Professional		$1,174.90	$1,621.81	$2,630.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility		$1,348.96	$1,348.96	$1,348.96
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 $1,230.27 / $1,862.09 / $2,884.03	Professional		$1,230.27	$1,862.09	$2,884.03
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 $1,288.25 / $1,862.09 / $3,019.95	Professional		$1,288.25	$1,862.09	$3,019.95
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 $1,318.26 / $1,621.81 / $3,090.30	Professional		$1,318.26	$1,621.81	$3,090.30
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 $1,380.38 / $1,819.70 / $2,754.23	Professional		$1,380.38	$1,819.70	$2,754.23