Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $3,715.35 / $10,715.19	Facility		$1,318.26	$3,715.35	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,096.48 / $2,818.38	Professional		$851.14	$1,096.48	$2,818.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $4,365.16 / $16,982.44	Facility		$1,995.26	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $977.24 / $1,548.82	Professional		$758.58	$977.24	$1,548.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $1,096.48	Facility		$933.25	$933.25	$1,096.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $21,379.62	Facility		$1,047.13	$1,513.56	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,258.93 / $1,819.70	Professional		$891.25	$1,258.93	$1,819.70
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 $831.76 / $1,258.93 / $1,862.09	Professional		$831.76	$1,258.93	$1,862.09
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 / $10,715.19	Facility		$100.00	$100.00	$10,715.19
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,047.13 / $1,995.26	Professional		$891.25	$1,047.13	$1,995.26
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $6,760.83 / $11,220.18	Facility		$3,890.45	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,047.13 / $1,659.59	Professional		$707.95	$1,047.13	$1,659.59