Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,137.96 / $9,549.93	Facility		$100.00	$2,137.96	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $263.03	Professional		$63.10	$104.71	$263.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,137.96 / $3,981.07	Facility		$707.95	$2,137.96	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $158.49	Professional		$66.07	$89.13	$158.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $64.57 / $74.13	Facility		$61.66	$64.57	$74.13
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 $74.13 / $114.82 / $194.98	Professional		$74.13	$114.82	$194.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,698.24 / $21,379.62	Facility		$1,230.27	$1,698.24	$21,379.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $120.23 / $194.98	Professional		$75.86	$120.23	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $37.15	Professional		$32.36	$33.11	$37.15
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,122.02	Facility		$100.00	$100.00	$1,122.02
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $109.65 / $169.82	Professional		$60.26	$109.65	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,073.80	Facility		$954.99	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $93.33 / $158.49	Professional		$63.10	$93.33	$158.49