Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $5,888.44 / $10,964.78	Facility		$1,047.13	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $891.25 / $4,168.69	Professional		$660.69	$891.25	$4,168.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $9,549.93 / $20,417.38	Facility		$2,511.89	$9,549.93	$20,417.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $891.25 / $1,513.56	Professional		$707.95	$891.25	$1,513.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $794.33 / $933.25	Facility		$776.25	$794.33	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $912.01 / $21,379.62	Facility		$660.69	$912.01	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $1,047.13 / $1,584.89	Professional		$389.05	$1,047.13	$1,584.89
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 / $1,096.48 / $1,659.59	Professional		$389.05	$1,096.48	$1,659.59
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 $758.58 / $891.25 / $1,659.59	Professional		$758.58	$891.25	$1,659.59
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 $691.83 / $912.01 / $1,445.44	Professional		$691.83	$912.01	$1,445.44