Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $8,912.51 / $12,022.64	Facility		$933.25	$8,912.51	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $1,479.11 / $5,128.61	Professional		$295.12	$1,479.11	$5,128.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,715.35 / $15,135.61	Facility		$1,698.24	$3,715.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $1,258.93 / $3,388.44	Professional		$295.12	$1,258.93	$3,388.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $1,258.93 / $21,379.62	Facility		$229.09	$1,258.93	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $562.34 / $2,691.53	Professional		$295.12	$562.34	$2,691.53
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 $295.12 / $794.33 / $2,818.38	Professional		$295.12	$794.33	$2,818.38
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 $275.42 / $1,348.96 / $2,884.03	Professional		$275.42	$1,348.96	$2,884.03
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 $302.00 / $1,096.48 / $2,818.38	Professional		$302.00	$1,096.48	$2,818.38