Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $2,570.40 / $10,715.19	Facility		$177.83	$2,570.40	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $346.74	Professional		$112.20	$173.78	$346.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $269.15	Professional		$107.15	$162.18	$269.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $125.89 / $21,379.62	Facility		$87.10	$125.89	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $281.84	Professional		$107.15	$165.96	$281.84
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 $107.15 / $165.96 / $288.40	Professional		$107.15	$165.96	$288.40
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 $776.25 / $776.25 / $776.25	Facility		$776.25	$776.25	$776.25
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $288.40	Professional		$100.00	$158.49	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,073.80	Facility		$954.99	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $269.15	Professional		$109.65	$169.82	$269.15