Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $8,912.51 / $11,748.98	Facility		$1,737.80	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,737.80 / $4,897.79	Professional		$1,412.54	$1,737.80	$4,897.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $6,918.31 / $16,982.44	Facility		$2,511.89	$6,918.31	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,659.59 / $2,884.03	Professional		$1,348.96	$1,659.59	$2,884.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $21,379.62	Facility		$1,174.90	$1,174.90	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,905.46 / $2,951.21	Professional		$1,288.25	$1,905.46	$2,951.21
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 $1,380.38 / $1,949.84 / $3,019.95	Professional		$1,380.38	$1,949.84	$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 $1,445.44 / $1,778.28 / $3,311.31	Professional		$1,445.44	$1,778.28	$3,311.31
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 $1,445.44 / $1,819.70 / $2,818.38	Professional		$1,445.44	$1,819.70	$2,818.38