Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $8,912.51 / $11,748.98	Facility		$954.99	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $1,862.09	Professional		$794.33	$1,000.00	$1,862.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,238.72 / $4,073.80	Facility		$707.95	$2,238.72	$4,073.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $933.25 / $1,548.82	Professional		$741.31	$933.25	$1,548.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $21,379.62	Facility		$630.96	$630.96	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,071.52 / $1,659.59	Professional		$724.44	$1,071.52	$1,659.59
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 $758.58 / $1,096.48 / $1,737.80	Professional		$758.58	$1,096.48	$1,737.80
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 / $1,949.84	Facility		$100.00	$100.00	$1,949.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $912.01 / $1,737.80	Professional		$741.31	$912.01	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $4,073.80	Facility		$1,096.48	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,071.52 / $1,659.59	Professional		$851.14	$1,071.52	$1,659.59