Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $8,912.51 / $11,748.98	Facility		$1,862.09	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,995.26 / $4,786.30	Professional		$1,548.82	$1,995.26	$4,786.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $3,019.95 / $7,943.28	Facility		$1,000.00	$3,019.95	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,737.80 / $3,162.28	Professional		$1,288.25	$1,737.80	$3,162.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,778.28 / $2,089.30	Facility		$1,737.80	$1,778.28	$2,089.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,778.28 / $21,379.62	Facility		$1,412.54	$1,778.28	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $2,344.23 / $3,630.78	Professional		$724.44	$2,344.23	$3,630.78
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 $724.44 / $2,344.23 / $3,715.35	Professional		$724.44	$2,344.23	$3,715.35
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 $4,073.80 / $4,073.80 / $4,073.80	Facility		$4,073.80	$4,073.80	$4,073.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,089.30 / $3,981.07	Professional		$1,819.70	$2,089.30	$3,981.07
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $6,606.93 / $10,471.29	Facility		$3,235.94	$6,606.93	$10,471.29
United Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,041.74 / $3,388.44	Professional		$1,548.82	$2,041.74	$3,388.44