Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,715.35 / $10,715.19	Facility		$630.96	$3,715.35	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $524.81 / $1,862.09	Professional		$407.38	$524.81	$1,862.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,818.38 / $7,943.28	Facility		$1,000.00	$2,818.38	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $489.78 / $794.33	Professional		$389.05	$489.78	$794.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $512.86	Facility		$436.52	$436.52	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $758.58 / $21,379.62	Facility		$512.86	$758.58	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $602.56 / $870.96	Professional		$416.87	$602.56	$870.96
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 $398.11 / $602.56 / $933.25	Professional		$398.11	$602.56	$933.25
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 / $2,398.83	Facility		$100.00	$100.00	$2,398.83
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $512.86 / $954.99	Professional		$436.52	$512.86	$954.99
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $7,244.36	Facility		$2,238.72	$4,365.16	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $512.86 / $812.83	Professional		$338.84	$512.86	$812.83