Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $8,912.51 / $11,748.98	Facility		$1,412.54	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,412.54 / $3,890.45	Professional		$1,148.15	$1,412.54	$3,890.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $6,918.31 / $15,135.61	Facility		$2,238.72	$6,918.31	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,412.54 / $2,398.83	Professional		$1,122.02	$1,412.54	$2,398.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,258.93 / $1,412.54	Facility		$1,174.90	$1,258.93	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $21,379.62	Facility		$1,047.13	$1,513.56	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $1,621.81 / $2,511.89	Professional		$389.05	$1,621.81	$2,511.89
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 $389.05 / $1,621.81 / $2,511.89	Professional		$389.05	$1,621.81	$2,511.89
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 $1,148.15 / $1,348.96 / $2,511.89	Professional		$1,148.15	$1,348.96	$2,511.89
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,606.93 / $10,471.29	Facility		$3,890.45	$6,606.93	$10,471.29
United Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,412.54 / $2,238.72	Professional		$1,071.52	$1,412.54	$2,238.72