Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $9,549.93 / $12,022.64	Facility		$4,897.79	$9,549.93	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $5,370.32 / $10,232.93	Professional		$4,466.84	$5,370.32	$10,232.93
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 $2,041.74 / $2,570.40 / $5,754.40	Professional		$2,041.74	$2,570.40	$5,754.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,786.30 / $6,025.60	Facility		$4,677.35	$4,786.30	$6,025.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,128.61 / $5,128.61 / $5,888.44	Professional		$5,128.61	$5,128.61	$5,888.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $8,317.64 / $8,317.64	Facility		$34.67	$8,317.64	$8,317.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $6,309.57 / $10,964.78	Professional		$2,041.74	$6,309.57	$10,964.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $8,317.64 / $21,379.62	Facility		$426.58	$8,317.64	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $6,165.95 / $10,232.93	Professional		$1,412.54	$6,165.95	$10,232.93
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 $4,786.30 / $5,495.41 / $10,471.29	Professional		$4,786.30	$5,495.41	$10,471.29
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 $3,548.13 / $5,370.32 / $8,912.51	Professional		$3,548.13	$5,370.32	$8,912.51