Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $9,120.11 / $12,022.64	Facility		$2,951.21	$9,120.11	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,951.21 / $6,165.95	Professional		$2,511.89	$2,951.21	$6,165.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,248.07 / $14,791.08	Facility		$1,698.24	$5,248.07	$14,791.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,884.03 / $4,677.35	Professional		$2,290.87	$2,884.03	$4,677.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,691.53 / $3,311.31	Facility		$2,570.40	$2,691.53	$3,311.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $3,235.94	Professional		$2,818.38	$2,818.38	$3,235.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $4,677.35 / $4,677.35	Facility		$34.67	$4,677.35	$4,677.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,548.13 / $6,025.60	Professional		$2,041.74	$3,548.13	$6,025.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $4,677.35 / $21,379.62	Facility		$426.58	$4,677.35	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $3,467.37 / $5,623.41	Professional		$741.31	$3,467.37	$5,623.41
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 $2,570.40 / $3,019.95 / $5,623.41	Professional		$2,570.40	$3,019.95	$5,623.41
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 $2,187.76 / $3,019.95 / $5,011.87	Professional		$2,187.76	$3,019.95	$5,011.87