Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,888.44 / $10,964.78	Facility		$1,698.24	$5,888.44	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,659.59 / $4,365.16	Professional		$1,288.25	$1,659.59	$4,365.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $16,982.44	Facility		$2,238.72	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,584.89 / $2,511.89	Professional		$1,202.26	$1,584.89	$2,511.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,778.28	Facility		$1,513.56	$1,513.56	$1,778.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,344.23 / $21,379.62	Facility		$1,548.82	$2,344.23	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,995.26 / $2,884.03	Professional		$1,380.38	$1,995.26	$2,884.03
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 $1,318.26 / $1,995.26 / $2,884.03	Professional		$1,318.26	$1,995.26	$2,884.03
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 $1,548.82 / $1,819.70 / $3,388.44	Professional		$1,548.82	$1,819.70	$3,388.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,754.40 / $8,511.38	Facility		$2,818.38	$5,754.40	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,621.81 / $2,691.53	Professional		$1,096.48	$1,621.81	$2,691.53