Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $8,912.51 / $12,022.64	Facility		$4,265.80	$8,912.51	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $4,677.35 / $8,912.51	Professional		$3,890.45	$4,677.35	$8,912.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $9,549.93 / $21,379.62	Facility		$2,238.72	$9,549.93	$21,379.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,754.23 / $5,370.32	Professional		$2,187.76	$2,754.23	$5,370.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,168.69 / $5,370.32	Facility		$4,073.80	$4,168.69	$5,370.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $4,466.84 / $5,128.61	Professional		$4,466.84	$4,466.84	$5,128.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $6,760.83 / $7,244.36	Facility		$34.67	$6,760.83	$7,244.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $5,495.41 / $9,549.93	Professional		$2,187.76	$5,495.41	$9,549.93
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $7,244.36 / $21,379.62	Facility		$602.56	$7,244.36	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $5,370.32 / $8,912.51	Professional		$1,412.54	$5,370.32	$8,912.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$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 $4,168.69 / $4,897.79 / $9,332.54	Professional		$4,168.69	$4,897.79	$9,332.54
United Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $2,691.53 / $6,760.83	Facility		$575.44	$2,691.53	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $4,677.35 / $7,762.47	Professional		$3,162.28	$4,677.35	$7,762.47