Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $2,570.40 / $10,715.19	Facility		$245.47	$2,570.40	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $616.60	Professional		$169.82	$229.09	$616.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,818.38 / $7,943.28	Facility		$1,000.00	$2,818.38	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $389.05	Professional		$169.82	$229.09	$389.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $186.21 / $208.93	Facility		$173.78	$186.21	$208.93
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 $181.97 / $263.03 / $398.11	Professional		$181.97	$263.03	$398.11
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 $181.97 / $269.15 / $426.58	Professional		$181.97	$269.15	$426.58
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 / $3,981.07	Facility		$100.00	$100.00	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $457.09	Professional		$169.82	$251.19	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $4,365.16 / $7,413.10	Facility		$2,398.83	$4,365.16	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $380.19	Professional		$162.18	$223.87	$380.19