Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $4,466.84 / $10,964.78	Facility		$630.96	$4,466.84	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,174.90 / $3,467.37	Professional		$338.84	$1,174.90	$3,467.37
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 $302.00 / $977.24 / $2,344.23	Professional		$302.00	$977.24	$2,344.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Facility		$323.59	$323.59	$323.59
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 $346.74 / $676.08 / $2,187.76	Professional		$346.74	$676.08	$2,187.76
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 $346.74 / $812.83 / $2,290.87	Professional		$346.74	$812.83	$2,290.87
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 $338.84 / $1,513.56 / $2,951.21	Professional		$338.84	$1,513.56	$2,951.21
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 $346.74 / $1,047.13 / $2,344.23	Professional		$346.74	$1,047.13	$2,344.23