Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $8,912.51 / $11,748.98	Facility		$1,348.96	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,445.44 / $3,019.95	Professional		$1,148.15	$1,445.44	$3,019.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $6,606.93 / $15,135.61	Facility		$2,238.72	$6,606.93	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,348.96 / $2,187.76	Professional		$1,047.13	$1,348.96	$2,187.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,513.56	Facility		$1,288.25	$1,288.25	$1,513.56
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 $1,230.27 / $1,737.80 / $2,570.40	Professional		$1,230.27	$1,737.80	$2,570.40
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 $1,122.02 / $1,737.80 / $2,691.53	Professional		$1,122.02	$1,737.80	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$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 $1,348.96 / $1,584.89 / $2,951.21	Professional		$1,348.96	$1,584.89	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $3,090.30 / $6,760.83	Facility		$1,479.11	$3,090.30	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,412.54 / $2,290.87	Professional		$954.99	$1,412.54	$2,290.87