Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $8,912.51 / $11,748.98	Facility		$1,023.29	$8,912.51	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,071.52 / $2,290.87	Professional		$870.96	$1,071.52	$2,290.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $6,456.54 / $15,135.61	Facility		$2,238.72	$6,456.54	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,047.13 / $1,659.59	Professional		$776.25	$1,047.13	$1,659.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,148.15	Facility		$977.24	$977.24	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,513.56 / $21,379.62	Facility		$1,023.29	$1,513.56	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,318.26 / $1,905.46	Professional		$933.25	$1,318.26	$1,905.46
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 $851.14 / $1,288.25 / $1,949.84	Professional		$851.14	$1,288.25	$1,949.84
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 $1,023.29 / $1,202.26 / $2,290.87	Professional		$1,023.29	$1,202.26	$2,290.87
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 $707.95 / $1,047.13 / $1,698.24	Professional		$707.95	$1,047.13	$1,698.24