Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $6,309.57 / $12,022.64	Facility		$1,230.27	$6,309.57	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $812.83 / $5,128.61	Professional		$660.69	$812.83	$5,128.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,715.35 / $15,135.61	Facility		$1,698.24	$3,715.35	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $776.25 / $1,380.38	Professional		$630.96	$776.25	$1,380.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $724.44 / $812.83	Facility		$676.08	$724.44	$812.83
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 $389.05 / $933.25 / $1,445.44	Professional		$389.05	$933.25	$1,445.44
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 / $933.25 / $1,445.44	Professional		$389.05	$933.25	$1,445.44
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 / $4,365.16	Facility		$100.00	$100.00	$4,365.16
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $776.25 / $1,479.11	Professional		$660.69	$776.25	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,754.40 / $8,511.38	Facility		$2,818.38	$5,754.40	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $812.83 / $1,288.25	Professional		$616.60	$812.83	$1,288.25