Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $8,912.51 / $11,748.98	Facility		$1,737.80	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,698.24 / $4,265.80	Professional		$1,445.44	$1,698.24	$4,265.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $9,549.93 / $20,892.96	Facility		$2,511.89	$9,549.93	$20,892.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,621.81 / $2,818.38	Professional		$1,258.93	$1,621.81	$2,818.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,548.82 / $1,819.70	Facility		$1,513.56	$1,548.82	$1,819.70
Cigna 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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,995.26 / $3,162.28	Professional		$794.33	$1,995.26	$3,162.28
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 $794.33 / $1,995.26 / $3,162.28	Professional		$794.33	$1,995.26	$3,162.28
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 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,778.28 / $3,388.44	Professional		$1,513.56	$1,778.28	$3,388.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $3,090.30 / $6,760.83	Facility		$1,479.11	$3,090.30	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,778.28 / $3,019.95	Professional		$1,318.26	$1,778.28	$3,019.95