Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $2,511.89 / $10,715.19	Facility		$371.54	$2,511.89	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $346.74 / $1,862.09	Professional		$257.04	$346.74	$1,862.09
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 $275.42 / $346.74 / $588.84	Professional		$275.42	$346.74	$588.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $302.00 / $354.81	Facility		$295.12	$302.00	$354.81
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 $309.03 / $446.68 / $691.83	Professional		$309.03	$446.68	$691.83
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 $323.59 / $457.09 / $724.44	Professional		$323.59	$457.09	$724.44
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 / $371.54	Facility		$100.00	$100.00	$371.54
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $416.87 / $794.33	Professional		$288.40	$416.87	$794.33
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $912.01 / $2,951.21	Facility		$316.23	$912.01	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $645.65	Professional		$281.84	$407.38	$645.65