Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $8,912.51 / $11,748.98	Facility		$1,174.90	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,174.90 / $2,290.87	Professional		$954.99	$1,174.90	$2,290.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,548.13 / $15,135.61	Facility		$1,698.24	$3,548.13	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,148.15 / $1,905.46	Professional		$851.14	$1,148.15	$1,905.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $21,379.62	Facility		$776.25	$776.25	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,258.93 / $1,995.26	Professional		$851.14	$1,258.93	$1,995.26
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 $912.01 / $1,318.26 / $2,089.30	Professional		$912.01	$1,318.26	$2,089.30
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 / $3,890.45	Facility		$100.00	$100.00	$3,890.45
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,122.02 / $2,137.96	Professional		$912.01	$1,122.02	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,754.40 / $8,511.38	Facility		$2,818.38	$5,754.40	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,288.25 / $1,905.46	Professional		$977.24	$1,288.25	$1,905.46