Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $4,265.80 / $10,964.78	Facility		$616.60	$4,265.80	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,148.15 / $3,235.94	Professional		$338.84	$1,148.15	$3,235.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,548.13 / $16,982.44	Facility		$2,238.72	$3,548.13	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $851.14 / $1,698.24	Professional		$288.40	$851.14	$1,698.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
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 / $1,819.70	Professional		$346.74	$676.08	$1,819.70
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 / $776.25 / $1,862.09	Professional		$346.74	$776.25	$1,862.09
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 / $6,760.83	Facility		$100.00	$100.00	$6,760.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,230.27 / $2,344.23	Professional		$338.84	$1,230.27	$2,344.23
United Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $9,332.54 / $13,803.84	Facility		$4,073.80	$9,332.54	$13,803.84
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $954.99 / $1,995.26	Professional		$338.84	$954.99	$1,995.26