Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $8,912.51 / $11,748.98	Facility		$3,467.37	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,388.44 / $6,456.54	Professional		$2,884.03	$3,388.44	$6,456.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $4,570.88 / $21,877.62	Facility		$1,412.54	$4,570.88	$21,877.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,467.37 / $5,623.41	Professional		$2,691.53	$3,467.37	$5,623.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,090.30 / $3,890.45	Facility		$3,019.95	$3,090.30	$3,890.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $3,715.35	Professional		$3,311.31	$3,311.31	$3,715.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $1,202.26 / $5,370.32	Facility		$34.67	$1,202.26	$5,370.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $4,168.69 / $6,918.31	Professional		$2,511.89	$4,168.69	$6,918.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $5,370.32 / $5,370.32	Facility		$562.34	$5,370.32	$5,370.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $4,073.80 / $6,606.93	Professional		$1,380.38	$4,073.80	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $630.96	Professional		$32.36	$33.11	$630.96
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 $3,019.95 / $3,548.13 / $6,760.83	Professional		$3,019.95	$3,548.13	$6,760.83
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 $2,630.27 / $3,630.78 / $5,754.40	Professional		$2,630.27	$3,630.78	$5,754.40